围手术期大出血管理：欧洲麻醉学会指南
本公众号每天分享一篇最新一期Anesthesia & Analgesia等SCI杂志的摘要翻译，敬请关注并提出宝贵意见
Management of severe perioperative bleeding: guidelines from the European Society of Anaesthesiology
背景与目的
围手术期出血的管理涉及多方面评估和策略，以确保病人得到恰当的护理。首先，它是识别和确定这些患者围手术期出血风险增加的重要策略。其次，应采用正确的策略来改善术前贫血和来使大循环和微循环足够平稳以优化病人对出血的耐受性。最后，有针对性的干预措施，应当应用以减少术中及术后出血，防止后续的发病率和死亡率。这些更新的指南的目的是为医疗保健专业人员提供最新证据的概述，以帮助确保改善患者的临床管理。
方 法
为实现这一更新，没有语言限制的对2011或2012（取决于搜索）到2015年的电子数据库进行搜索。
结 果
搜索出了18334篇文章。对所有的文章进行了评估，参考这些新的证据并修订了现有的2013年指南。
结 论
这一更新包括修改现有的提议，包括了对其措辞或在提议等级的变化方面进行了修改，并增加了新的提议。最后的指南草案公示在欧洲麻醉学会网站四周以供审查。整理所有的意见，并对指南方针进行了适当修订。本出版物反映了这项工作的成果。
原始文献摘要
Correspondence to Sibylle A. Kozek-Langenecker, Department of Anaesthesiology & Intensive Care, Evangelical Hospital Vienna, Hans-Sachs-Gasse 10-12, 1180 Vienna, Austria; E-mail: sibylle.kozek@aon.at 0265-0215 Copyright # 2017 European Society of Anaesthesiology. All rights reserved. DOI:10.1097/EJA.0000000000000630
The management of perioperative bleeding involves multiple assessments and strategies to ensure appropriate patient care. Initially, it is important to identify those patients with an increased risk of perioperative bleeding. Next, strategies should be employed to correct preoperative anaemia and to stabilise macrocirculation and microcirculation to optimise the patient’s tolerance to bleeding. Finally, targeted interventions should be used to reduce intraoperative and postoperative bleeding, and so prevent subsequent morbidity and mortality. The objective of these updated guidelines is to provide healthcare professionals with an overview of the most recent evidence to help ensure improved clinical management of patients. For this update, electronic databases were searched without language restrictions from 2011 or 2012 (depending on the search) until 2015. These searches produced 18 334 articles. All articles were assessed and the existing 2013 guidelines were revised to take account of new evidence. This update includes revisions to existing recommendations with respect to the wording, or changes in the grade of recommendation, and also the addition of new recommendations. The final draft guideline was posted on the European Society of Anaesthesiology website for four weeks for review. All comments were collated and the guidelines were amended as appropriate. This publication reflects the output of this work.
麻醉学文献进展分享
联系我们