miércoles, 16 de septiembre de 2015

Hemoglobina, transfusión y cirugía cardiaca/Hemoglobin, transfusion and cardiac surgery

Anestesia y Medicina del Dolor

Optimización de la hemoglobina y estrategias de transfusión en pacientes programados para cirugía cardiaca
Hemoglobin optimization and transfusion strategies in patients undergoing cardiac surgery.
World J Cardiol. 2015 Jul 26;7(7):377-82. doi: 10.4330/wjc.v7.i7.377.
Although red blood cells (RBCs) transfusion is sometimes associated with adverse reactions, anemia could also lead to increased morbidity and mortality in high-risk patients. For these reasons, the definition of perioperative strategies that aims to detect and treat preoperative anemia, prevent excessive blood loss, and define "optimal" transfusion algorithms is crucial. Although the treatment with preoperative iron and erythropoietin has been recommended in some specific conditions, several controversies exist regarding the benefit-to-risk balance associated with these treatments. Further studies are needed to better define the indications, dosage, and route of administration for preoperative iron with or without erythropoietin supplementation. Although restrictive transfusion strategies in patients undergoing cardiac surgery have been shown to effectively reduce the incidence and the amount of RBCs transfusion without increase in side effects, some high-risk patients (e.g., symptomatic acute coronary syndrome) could benefit from higher hemoglobin concentrations. Despite all efforts made last decade, a significant amount of work remains to be done to improve hemoglobin optimization and transfusion strategies in patients undergoing cardiac surgery.
KEYWORDS: Anemia; Blood transfusion; Cardiac surgery; Risk factor; Transfusion threshold
Modulo CEEA Leon, Gto. 

Anestesiología y Medicina del Dolor
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