Llau J V, Ferrandis R, Sierra P, Hidalgo F, Cassinello C, Gómez-Luque A, Quintana M, Amezaga R, Gero M, Serrano A, Marcos P
Servicio de Anestesiología-Reanimación y Terapéutica del Dolor, Hospital Universitari Doctor Peset, SEDAR, Valencia, España.
Servicio de Anestesiología-Reanimación y Terapéutica del Dolor, Hospital Universitari i Politècnic La Fe, SEDAR, Valencia, España.
Rev Esp Anestesiol Reanim (Engl Ed). 2020 Aug-Sep;67(7):391-399. doi: 10.1016/j.redar.2020.05.007. Epub 2020 May 23.
The infection by the coronavirus SARS-CoV-2, which causes the disease called COVID-19, mainly causes alterations in the respiratory system. In severely ill patients, the disease often evolves into an acute respiratory distress syndrome that can predispose patients to a state of hypercoagulability, with thrombosis at both venous and arterial levels. This predisposition presents a multifactorial physiopathology, related to hypoxia as well as to the severe inflammatory process linked to this pathology, including the additional thrombotic factors present in many of the patients. In view of the need to optimise the management of hypercoagulability, the working groups of the Scientific Societies of Anaesthesiology-Resuscitation and Pain Therapy (SEDAR) and of Intensive, Critical Care Medicine and Coronary Units (SEMICYUC) have developed a consensus to establish guidelines for actions to be taken against alterations in haemostasis observed in severely ill patients with COVID-19. These recommendations include prophylaxis of venous thromboembolic disease in these patients, and in the peripartum, management of patients on long-term antiplatelet or anticoagulant treatment, bleeding complications in the course of the disease, and the interpretation of general alterations in haemostasis.
由新型冠状病毒SARS-CoV-2引起的疾病COVID-19，其感染主要导致呼吸系统的改变。在重症患者中，该疾病常演变为急性呼吸窘迫综合征，可使患者易处于高凝状态，出现静脉和动脉血栓形成。这种易感性呈现多因素病理生理学，与缺氧以及与此病理相关的严重炎症过程有关，包括许多患者中存在的额外血栓形成因素。鉴于优化高凝状态管理的必要性，麻醉复苏与疼痛治疗科学协会（SEDAR）和重症、危重病医学与冠心病科科学协会（SEMICYUC）的工作组已达成共识，以制定针对COVID-19重症患者观察到的止血改变应采取行动的指南。这些建议包括对这些患者进行静脉血栓栓塞性疾病的预防，以及在围产期，对长期接受抗血小板或抗凝治疗的患者进行管理、疾病过程中的出血并发症以及止血一般改变的解读。
