Revisiones bibliográficas. Documentación científica en Ortopedia y Traumatología, medicina deportiva, artroscopia, artroplastia y de todas las patologías del sistema Músculo-Esquelético
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.
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.
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.
Seattle Science Foundation is a non-profit organization dedicated to the international collaboration among physicians, scientists, technologists, engineers and educators. The Foundation’s training facilities and extensive internet connectivity have been designed to foster improvements in health care through professional medical education, training, creative dialogue and innovation.
NOTE: All archived recorded lectures are available for informational purposes only and are only eligible for self-claimed Category II credit. They are not intended to serve as, or be the basis of a medical opinion, diagnosis, prognosis, or treatment for any particular patient.
Reporte de conocimientos, creencias y actitudes en calidad de atención y seguridad del paciente en alumnos de pregrado: validando el cuestionario APSQ-III modificado Ezequiel García Elorrio, Dolores Macchiavello, Viviana Rodriguez, Yael Catalano, Giuliana Corna, Josefina Dahinten, Marina Ontivero (Argentina) Medwave 2016 Dic;16(11):e6809
NOTA TÉCNICA
Carcinoma de células basales pigmentado simulando un melanoma de extensión superficial Paula Hasbún Acuña, Roberto Cullen Aravena, César Maturana Donaire, Raúl Ares Mora, Ninoska Porras Kusmanic (Chile) Medwave 2016 Dic;16(11):e6805
EPISTEMONIKOS
¿Son efectivos los probióticos para prevenir la diarrea del viajero? Yazmín Pinos, Victoria Castro-Gutiérrez, Gabriel Rada (Chile) Medwave 2016;16(Suppl5):e6807
¿Cuál es el rol de la proteína C activada en el tratamiento de la sepsis? Juan Alvarado, Ricardo Castro (Chile) Medwave 2016; 16(Suppl5):e6801
ESPECIAL CARDIOLOGÍA
Síncope: electrocardiograma y pruebas de función autonómica William Uribe, Adrián Baranchuk, Federico Botero (Colombia, Canadá) Medwave 2016;16(Suppl 4):e6816
Arritmias supraventriculares: aspectos electrocardiográficos Antoni Bayés de Luna (España) Medwave 2016;16(Suppl 4):e6815
Factores de riesgo de fibrilación auricular en el post operatorio de cirugía de revascularización coronaria: papel de la apnea obstructiva del sueño Amro Qaddoura, Adrian Baranchuk (Canadá) Medwave 2016;16(Suppl4).e6810
El equipo de editorial de Medwave le desea una muy felíz Navidad.
