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Inicio Revista Colombiana de Anestesiología Técnicas de ahorro sanguíneo en cirugía
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Vol. 39. Núm. 4.
Páginas 545-559 (noviembre - enero 2011)
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Vol. 39. Núm. 4.
Páginas 545-559 (noviembre - enero 2011)
ARTÍCULO DE REVISIÓN
Open Access
Técnicas de ahorro sanguíneo en cirugía
Blood-Saving Techniques in Surgery
Visitas
8621
Daniel Rivera Tocancipá
, Antonio Pérez Ferrer**,
* Anestesiólogo de trasplante. Epidemiólogo. Coordinador, Posgrado Anestesiología, Facultad de Medicina, Servicio de Anestesiología y Reanimación, Universidad Surcolombiana. Neiva, olombia.
** Anestesiólogo pediátrico y de trasplantes, Hospital Universitario La Paz. Madrid, España.
Este artículo ha recibido

Under a Creative Commons license
Información del artículo
RESUMEN
Introducción

Las transfusiones sanguíneas son un trasplante tisular con morbimortalidad y costos.

Metodología

Se describen estrategias acordes a la literatura vigente con una revisión narrativa de los últimos diez años.

Resultados y Conclusiones

Nos enfrentamos a pacientes añosos, con comorbilidades y para procedimientos complejos. Se deben racionalizar las transfusiones, protocolizando técnicas, mejorando las condiciones del paciente, disminuyendo las pérdidas sanguíneas operatorias, recuperando la sangre perdida y estableciendo la autodonación con un programa institucional.

Key words:
Blood transfusion
morbidity
blood transfusion
autologous
perioperative period. (Source: MeSH, NLM).
Palabras clave::
Transfusión sanguínea
morbilidad
transfusión de sangre autóloga
periodo perioperatorio. (Fuente: DeCS, BIREME).
SUMMARY
Introduction

Blood transfusions are tissue transplants with morbimortality and costs involved.

Methodology

A description ofthe strategies consistent with the current literature that offers a review of de last decade.

Results and Conclusions

We have to deal with elderly patients with comorbidities who will undergo complex procedures. Blood transfusions must be streamlined, thorugh the development of technicalprotocols, improving the patient's condition, decreasing operative blood loss, recovering any blood losses and establishing an institutional program for autologous blood donation.

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REFERENCES
[1.]
LT. Goodnough.
Risks of blood transfusion.
Crit Care Med, 31 (2003), pp. S678-686
[2.]
P.C. Hébert.
Clinical consequences of anemia and red cell.
Crit Care Clin., 20 (2004), pp. 225-235
[3.]
S. Verma, M. Eisses, M. Ricards.
Blood conservation strategies in pediatric anesthesia.
Anesthesiol Clin., 29 (2009), pp. 337-351
[4.]
A. Ferrer.
Medicina Transfusional.
Ed. Médica Panamericana, (2009),
[5.]
E.M. Keating.
Preoperative evaluation and methods to reduce blood use in orthopedic surgery.
Anesthesiol Clin North America., 23 (2005), pp. 305-313
[6.]
C. Madjdpour, V. Heindl, D.R. Spahn.
Risks, benefits, alternatives and indications of allogenic blood transfusion.
Minerva Anestesiol., 72 (2006), pp. 283-298
[7.]
L.T. Goodnough, A. Shander, J.L. Spivak.
Detection, evaluation and management of anemia in the elective surgical patient.
Anesth Analg., 101 (2005), pp. 1858-1861
[8.]
J.D. Cook.
Diagnosis and management of iron-deficiency anaemia.
Best Pract Res Clin Haematol., 18 (2005), pp. 319-332
[9.]
A.M. Ganzoni.
Intravenous iron-dextran: Therapeutic and experimental possibilities.
Schweiz Med Wochenschr., 100 (1970), pp. 301-303
[10.]
P. Beris.
The use of iron to increase red cell mass.
Can J Anesth., 50 (2003), pp. S3-S9
[11.]
Z. Madrazo González, A. García Barrasa, L. Rodríguez Lorenzo.
Hierro Intravenoso.
Cir Esp., 86 (2009), pp. 196-203
[12.]
D. Kendoff, J. Tomeczkowski, H. Gombotz.
Preoperative anemia in orthopedic surgery: Clinical impact, dianostics and teatmente.
Orthopade., (2011, Sep 17),
[13.]
P.C. Hébert, M.A. Blajchman, D.J. Cook.
Do blood transfusions improve outcomes related to mechanical ventilation?.
Chest., 119 (2001), pp. 1850-1857
[14.]
S. Freeman, M. DeVita.
et al.
Randomized controlled trials are needed to determine appropriate blood transfusion strategies in patients with acute coronary syndromes., 9 (2005), pp. e6
[15.]
S.V. Rao, J.G. Jollis, R.Z. Harrington.
Relationship of blood transfusion and clinical outcomes in patients with acute coronary syndromes.
JAMA., 292 (2004), pp. 1555-1562
[16.]
A. Shander.
Anemia in the critically ill.
Crit Car Clin, (2004), pp. 159-168
[17.]
M. Izuel Rami, M. Gómez Barrera, I. Villar Fernández.
Análisis del impacto presupuestario de la implantación de medidas de ahorro de sangre en cirugía de urgencia.
Med Clin (Barcelona)., 128 (2007), pp. 7-11
[18.]
M. Kuriyan, J.L. Carson.
Anemia and clinical outcomes.
Anhestesiol Clin North America., 23 (2005), pp. 315-325
[19.]
J. Lacroix, P.C. Hábert, J.S. Hutchinson.
Transfusion strategies for patients in pediatric intensive care units.
N Engl J Med., 356 (2007), pp. 1609-1619
[20.]
R.G. Fields, F.J. Gencorelli, R.S. Litman.
Anesthetic management of the pediatric bleending tonsil.
Pediatr Anaesth., 20 (2010), pp. 982-986
[21.]
American Society of Anesthesiologists.
Practice Guidelines for Perioperative Blood Transfusion.
Anesthesiology, 105 (2006), pp. 198-208
[22.]
R.J. Santora, F.A. Moore.
Monitoring trauma and intensive care unit resuscitation with tissue hemoglobin oxygen saturation.
Crit Care., 13 (2009), pp. S10
[23.]
R.N. Bilkovski, E.P. Rivers, H.M. Horst.
Targeted resuscitation strategies after injury.
Curr Opin Crit Care., 10 (2004), pp. 529-538
[24.]
L.M. Napolitano.
Resuscitation endpoints in trauma.
TATM., 6 (2005), pp. 8-14
[25.]
M.J. García.
Pérdidas sanguíneas permisibles, modelo exponencial.
Rev. Colomb. Anestesiol., 37 (2009), pp. 255-262
[26.]
P.M. Mannucci, M. Levi.
Prevention and treatment of major blood loss.
N Engl J Med., 356 (2007), pp. 2301-2311
[27.]
British Committee for Standards in Haematology, D. Stainsby, S. MacLennan.
Guidelines on the management of massive blood loss.
Br J Haematol, 135 (2006), pp. 634-641
[28.]
R.G. Hahn.
Volume kinetics for infusion fluids.
Anesthesiology., 113 (2010), pp. 470-481
[29.]
D. Chappell, M. Jacob, K. Hofmann-Kiefer.
A rational approach to perioperative fluid management.
Anesthesiology., 109 (2008), pp. 723-740
[30.]
J. Ahonen, V. Stefanovic, R. Lassila.
Management of post-partum haemorrhage.
Acta Anaesthesiol Scand., 54 (2010), pp. 1164-1178
[31.]
M. Levi, J.H. Levy, H.F. Andersen.
Safety of recombinant activated factor VII in randomized clinical trials.
N Engl J Med., 363 (2010), pp. 1791-1800
[32.]
C. McLintock.
Obstetric haemorrhage.
Thromb Res., 123 (2009), pp. S30-S34
[33.]
F. Breathnach, M. Geary.
Uterine atony: definition, prevention, nonsurgical management, and uterine tamponade.
Semin Perinatol., 33 (2009), pp. 82-87
[34.]
M. Burtelow, E. Riley, M. Druzin.
How we treat: management of life-threatening primary postpartum hemorrhage with a standardized massive transfusion protocol.
Transfusion., 47 (2007), pp. 1564-1572
[35.]
L.M. Aledort.
Off-label use of recombinant activated factor VII - safe or not safe?.
N Engl J Med., 363 (2010), pp. 1853-1854
[36.]
C.J. Hause, K. Boffard, R. Dutton.
Results of the control trial: efficacy and safety of recombinant activated factor VII in the management of refractory traumatic hemorrhage.
J Trauma., 69 (2010), pp. 489-500
[37.]
K.S. Schick, J.M. Fertmann, K.W. Jauch.
Prothrombin complex concentrate in surgical patients: retrospective evaluation of vitamin K antagonist reversal and treatment of severe bleeding.
Crit Care., 13 (2009), pp. R191
[38.]
C.A. Leissinger, P.M. Blatt, W.K. Hoots.
Role of prothrombin complex concentrates in reversing warfarin anticoagulation: a review of the literature.
Am J Hematol., 83 (2008), pp. 137-143
[39.]
CRASH-2 collaborators, I. Roberts, H. Shakur.
The importance of early treatment with tranexamic acid in bleeding trauma patients: an exploratory analysis of the CRASH-2 randomised controlled trial.
Lancet, 377 (2011), pp. 1096-1101
[40.]
D. Henry, P. Carless, D. Fergusson.
The safety of aprotinin and lysine-derived antifibrinolytic drugs in cardiac surgery: a meta-analysis.
CMAJ., 180 (2009), pp. 183-193
[41.]
B. Ozgonenel, M. Rajpurkar, J.M. Lusher.
How do you treat bleeding disorders with desmopressin?.
Postgrad Med J., 83 (2007), pp. 159-163
[42.]
M.D. McEvoy, S.T. Reeves, J.G. Reves.
Aprotinin in cardiac surgery: a review of conventional and novel mechanisms of action.
Anesth Analg., 105 (2007), pp. 949-962
[43.]
R.S. Purdham.
Reduced blood loss with hemodynamic stability during controlled hypotensive anesthesia for Lefort I maxillary osteotomy using high dose fentanyl: a retrospective study.
CRNA., 7 (1996), pp. 33-46
[44.]
R Carrillo-Esper, R. Sánchez-García.
Coagulopatía dilucional.
Revista Mexicana de Anestesiología, 31 (2008), pp. S129-S131
[45.]
R.M. Jones, C.E. Moulton, K.J. Hardy.
Central venous pressure and its effect on blood loss during liver resection.
Br J Surg., 85 (1998), pp. 1058-1060
[46.]
N.B. Scott, H. Kehlet.
Regional anaesthesia and surgical morbidity.
Br J Surg., 75 (1988), pp. 299-304
[47.]
C. Schonauer, A. Bocchetti, G. Barbagallo.
Positioning on surgical table.
Eur Spine J, 13 (2004), pp. S50-S55
[48.]
J.C.E. Jiménez.
Recomendaciones medicoquirúrgicas para disminuir el uso y pérdida de derivados sanguíneos.
Rev Colomb Cir., 20 (2005), pp. 105-117
[49.]
J.F. Kragh, M.L. O Neill, D.F. Beebe.
Survey of the indications for use of emergency tourniquets.
J Spec Oper Med, 11 (2011), pp. 30-38
[50.]
J.G. Perkins, A.P. Cap, B.M. Weiss.
Massive transfusion and nonsurgical hemostatic agents.
Crit Care Med., 36 (2008), pp. S325-S339
[51.]
D.R. Spahn, M. Casutt.
Eliminating blood ttransfusions: new aspects and perspective.
Anesthesiology., 93 (2000), pp. 242-255
[52.]
L.T. Goodnough.
Autologous blood donation.
Anestesiol Clin North America., 23 (2005), pp. 263-270
[53.]
J.A. Napier, M. Bruce, J. Chapman.
Guidelines for autologus transfusion II. Perioperative haemodilution and cell salvage.
Br J Anaesth, 78 (1997), pp. 768-771
[54.]
E. Bisbe, M. Sáez, N. Nomen.
Eritropoyetina sólo o como coadyuvante del programa de donación de sangre autóloga en cirugía ortopédica mayor.
Rev Esp Anestesiol Reanim., 50 (2003), pp. 395-400
[55.]
K. Singbartl, P. Innerhofer, J. Radvan.
Hemostasis and hemodilution: a quantitative mathematical guide for clinical practice.
Anesth Analg., 96 (2003), pp. 929-935
[56.]
G. Singbartl.
Pre-operative autologous blood donation: clinical parameters and efficacy.
Blood Transfus., 9 (2011), pp. 10-18
[57.]
M.E. Brecher, M. Rosenfeld.
Mathematical and computer modelling of acute normovolemic hemodilution.
Transfusion., 34 (1994), pp. 176-179
[58.]
M. Muñoz Gómez, E. Naveira Abeigón, A. Campos Garrigues.
Usefulness of autologous transfusion and erythropoietin in surgical and critically ill patients.
Med Clin (Barc), 120 (2003), pp. 357-358
[59.]
M. Muñoz, S.R. Leal Noval, J.A. García Erce.
¿Eritropoyetina humana recombinante, ¿Una alternativa válida para el tratamiento de la anemia del paciente crítico?.
Med Clin (Barc)., 132 (2009), pp. 749-755
[60.]
P. van der Linden, S. De Hert, N. Mathieu.
Tolerance of acute isovolemic hemodilution.
Effect of anesthetic depth. Anesthesiology., 99 (2003), pp. 97-104
[61.]
D.L. Bourke, T.C. Smith.
Estimating allowable hemodilution.
Anesthesiology., 41 (1974), pp. 609-612
[62.]
G.L. Bryson, A. Laupacis, G.A. Wells.
Does acute nor - movolemic hemodilution reduce perioperative allogeneic transfusion? A metaanalysis. The International Study of Perioperative Transfusion.
Anesth Analg., 86 (1998), pp. 9-15
[63.]
D.F. Jiménez, C.M. Barone.
Intraoperative autologous blood transfusion in the surgical correction of cran- iosynostosis.
Neurosurgery., 37 (1995), pp. 1075-1079
[64.]
J.H. Waters.
Red blood cell recovery and reinfusion.
Anestesiol Clin North America., 23 (2005), pp. 283-294
[65.]
H.V. Schaff, J.M. Hauer, W.R. Bell.
Autotrasfu- sion of shed mediastinal blood after cardiac sur- gery: a prospective study.
J Thorac Cardiovasc Surg., 75 (1978), pp. 632-641
[66.]
M. Muñoz Gómez, J. García Vallejo, A. López-Andrade Jurado.
Autotrasfusion after orthopedic surgery: Analysis of quality, safety and efficacy of salvaged shed blood.
Rev Esp Anestesiol Reanim., 48 (2001), pp. 131-140
[67.]
F. Bhanji, M.E. Mancini, E. Sinz.
Part 16: education, implementation, and teams: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care.
Circulation., 122 (2010), pp. S920-S933
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