martes, 3 de enero de 2017

Anemia perioperatoria / Peri-operative management of anaemia

Enero 3 2017. No. 2558






Declaración de consenso internacional sobre el manejo perioperatorio de la anemia y la deficiencia de hierro.
International consensus statement on the peri-operative management of anaemia and iron deficiency.
Anaesthesia. 2016 Dec 20. doi: 10.1111/anae.13773. [Epub ahead of print]
Abstract
Despite current recommendations on the management of pre-operative anaemia, there is no pragmatic guidance for the diagnosis and management of anaemia and iron deficiency in surgical patients. A number of experienced researchers and clinicians took part in an expert workshop and developed the following consensus statement. After presentation of our own research data and local policies and procedures, appropriate relevant literature was reviewed and discussed. We developed a series of best-practice and evidence-based statements to advise on patient care with respect to anaemia and iron deficiency in the peri-operative period. These statements include: a diagnostic approach for anaemia and iron deficiency in surgical patients; identification of patients appropriate for treatment; and advice on practical management and follow-up. We urge anaesthetists and peri-operative physicians to embrace these recommendations, and hospital administrators to enable implementation of these concepts by allocating adequate resources.
KEYWORDS: anaemia; iron; pre-operative assessment; transfusion
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Abordaje multimodal para conservación de sangre en el paciente quirúrgico
Multimodal approach to blood conservation in the surgical patient.
Niger J Clin Pract. 2015 May-Jun;18(3):422-5. doi: 10.4103/1119-3077.153249.
Abstract
Allogeneic blood remains a scarce and expensive resource, even as the risks of disease transmission and other complications associated with blood transfusion are well known. Blood conservation, however, is a quality-of-care concept that transcends these and other known and unknown complications of transfusion, to involve a gamut of strategies meant to prevent exposure of patients to allogeneic blood. In urging a halt to incessant allogeneic blood transfusion, we report three cases to highlight the benefits of multimodal multidisciplinary collaboration in blood conservation. The three patients were chosen on account of either religious objection to any blood transfusion or the likelihood of exposure to several units of allogeneic blood. The blood conservation plan proposed for each patient was discussed with the respective surgeon and patient. Multimodal multidisciplinary approach to blood conservation utilising combination of strategies best suited for each individual patient will remarkably reduce the exposure of patients to allogeneic blood thereby ensuring better use of the scarce resource, and and preventing potential clinical complications and spiritual trespass of Jehovah's Witnesses.
Recuperación de células lavadas en pacientes quirúrgicos: Una revisión y meta-análisis de ensayos prospectivos aleatorios bajo PRISMA.
Washed cell salvage in surgical patients: A review and meta-analysis of prospective randomized trials under PRISMA.
Medicine (Baltimore). 2016 Aug;95(31):e4490. doi: 10.1097/MD.0000000000004490.
Abstract
BACKGROUND: Cell salvage is commonly used as part of a blood conservation strategy. However concerns among clinicians exist about the efficacy of transfusion of washed cell salvage. CONCLUSIONS: Washed cell salvage is efficacious in reducing the need for allogeneic RBC transfusion and risk of infection in surgery.
5to Curso Internacional de Anestesiología cardiotorácica, vascular, ecocardiografía y circulación extracorpórea. SMACT
Mayo 4-6, 2017, Mexicali, México
Informes Dr. Hugo Martínez Espinoza bajamed@hotmail.com
Regional Anesthesiology and Acute Pain Medicine Meeting
April 6-8, 2017, San Francisco, California, USA
ASRA American Society of Regional Anesthesia and Pain Medicine
California Society of Anesthesiologists
Annual Meeting April 27-30, 2017
San Francisco California
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