Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt am Main, Germany.
Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt am Main, Germany.
J Cardiothorac Vasc Anesth. 2020 Apr;34(4):1060-1073. doi: 10.1053/j.jvca.2019.06.047. Epub 2019 Jul 4.
Anemia is common in patients with cardiac disease. Iron deficiency is the cause of anemia in about 80% of all cases. Preoperative anemia is associated with an increased morbidity and mortality in patients undergoing cardiac surgery. The risk of receiving red blood cell transfusions, which are potentially associated with severe side effects, is very high in these patients. Patient Blood Management (PBM) is a multidisciplinary approach to manage anemia, minimize unnecessary blood loss, and optimize transfusion therapy. PBM comprises 3 pillars: (1) detection and treatment of preoperative anemia, (2) reduction of perioperative blood loss, and (3) optimization of allogeneic blood therapy. The World Health Organization has urged all Member States to implement PBM. This narrative review focuses on pre-, intra-, and postoperative strategies to detect, prevent, and treat anemia as part of PBM in cardiac surgery.
贫血在心脏病患者中很常见。约 80%的贫血是由缺铁引起的。术前贫血与心脏手术患者的发病率和死亡率增加有关。这些患者接受红细胞输血的风险非常高,输血可能会带来严重的副作用。患者血液管理(PBM)是一种多学科方法,用于管理贫血、最大限度地减少不必要的失血,并优化输血治疗。PBM 由 3 个支柱组成:(1)检测和治疗术前贫血,(2)减少围手术期失血,(3)优化同种异体血液治疗。世界卫生组织敦促所有会员国实施 PBM。本叙述性综述重点介绍了心脏手术中 PBM 的术前、术中和术后策略,以检测、预防和治疗贫血。