• Best Pract Res Clin Anaesthesiol · Mar 2013

    Review

    Pillar 2: minimising bleeding and blood loss.

    • Elvira Bisbe and Luís Moltó.
    • Hospital Universitari Mar-Esperança, IMIM Hospital del Mar Medical Research Institute, Barcelona, Spain. ebisbe@parcdesalutmar.cat
    • Best Pract Res Clin Anaesthesiol. 2013 Mar 1;27(1):99-110.

    AbstractOne of the main factors that contributes to the need for transfusion in the surgical patient is excessive blood loss. Pillar 2 of patient blood management (PBM) includes all the strategies to reduce bleeding and preserve the patient's own blood, designed with an aim to reducing or avoiding transfusion. Some of these strategies, such as identifying and planning the management of patients at high risk of bleeding, can be implemented as early as at the preoperative assessment visit. During the intra-operative period, local haemostasis is the most important factor in the control of bleeding; in this context, therefore, surgical technique and meticulous haemostasis are fundamental measures. However, there are also additional anaesthetic techniques that can help reduce blood loss and transfusion requirements, such as the use of pharmacological or haemostatic agents. After surgery, PBM continues in the postoperative recovery unit or on the ward with the monitoring and management of postoperative bleeding. The blood lost via drains can be filtered, washed and reinfused, if needed.Copyright © 2013 Elsevier Ltd. All rights reserved.

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