Donizetti Enis, Perini Fernanda Vieira, Dos Reis Rodrigues Roseny, Montano-Pedroso Juan Carlos, Oliveira Luciana Correa, Parolin Rizzo Silvia Renata Cornélio, Rabello Guilherme, Langhi Dante Mario
Hospital Sírio Libanês, São Paulo, SP, Brazil.
Grupo GSH - Gestor de Serviços de Hemoterapia, São Paulo, SP, Brazil; Associação Beneficente Síria HCOR, São Paulo, SP, Brazil.
Hematol Transfus Cell Ther. 2024 Apr;46 Suppl 1(Suppl 1):S53-S59. doi: 10.1016/j.htct.2024.02.021. Epub 2024 Mar 23.
Hemostasis plays a critical role in surgical procedures and is essential for a successful outcome. Advances in hemostatic agents offer new approaches to controlling bleeding thereby making surgeries safer. The appropriate choice of these agents is crucial. Volume replacement, another integral part of Patient Blood Management (PBM), maintains adequate tissue perfusion, preventing cellular damage. Individualization in fluid administration is vital with the choice between crystalloids and colloids depending on each case. Colloids, unlike crystalloids, increase oncotic pressure, contributing to fluid retention in the intravascular space. Understanding these aspects is essential to ensure safe and effective surgery, minimizing complications related to blood loss and maintaining the patient's hemodynamic status.
止血在外科手术中起着关键作用,是手术成功的必要条件。止血剂的进展为控制出血提供了新方法,从而使手术更安全。正确选择这些药剂至关重要。容量补充是患者血液管理(PBM)的另一个重要组成部分,可维持足够的组织灌注,防止细胞损伤。液体管理的个体化至关重要,根据具体情况在晶体液和胶体液之间进行选择。与晶体液不同,胶体液可增加胶体渗透压,有助于血管内空间的液体潴留。了解这些方面对于确保安全有效的手术、将与失血相关的并发症降至最低以及维持患者的血流动力学状态至关重要。