Strategies to prevent blood loss and reduce transfusion in emergency general surgery, WSES-AAST consensus paper

Author:

Coccolini Federico,Shander Aryeh,Ceresoli Marco,Moore Ernest,Tian Brian,Parini Dario,Sartelli Massimo,Sakakushev Boris,Doklestich Krstina,Abu-Zidan Fikri,Horer Tal,Shelat Vishal,Hardcastle Timothy,Bignami Elena,Kirkpatrick Andrew,Weber Dieter,Kryvoruchko Igor,Leppaniemi Ari,Tan Edward,Kessel Boris,Isik Arda,Cremonini Camilla,Forfori Francesco,Ghiadoni Lorenzo,Chiarugi Massimo,Ball Chad,Ottolino Pablo,Hecker Andreas,Mariani Diego,Melai Ettore,Malbrain Manu,Agostini Vanessa,Podda Mauro,Picetti Edoardo,Kluger Yoram,Rizoli Sandro,Litvin Andrey,Maier Ron,Beka Solomon Gurmu,De Simone Belinda,Bala Miklosh,Perez Aleix Martinez,Ordonez Carlos,Bodnaruk Zenon,Cui Yunfeng,Calatayud Augusto Perez,de Angelis Nicola,Amico Francesco,Pikoulis Emmanouil,Damaskos Dimitris,Coimbra Raul,Chirica Mircea,Biffl Walter L.,Catena Fausto

Abstract

AbstractEmergency general surgeons often provide care to severely ill patients requiring surgical interventions and intensive support. One of the primary drivers of morbidity and mortality is perioperative bleeding. In general, when addressing life threatening haemorrhage, blood transfusion can become an essential part of overall resuscitation. However, under all circumstances, indications for blood transfusion must be accurately evaluated. When patients decline blood transfusions, regardless of the reason, surgeons should aim to provide optimal care and respect and accommodate each patient’s values and target the best outcome possible given the patient’s desires and his/her clinical condition. The aim of this position paper was to perform a review of the existing literature and to provide comprehensive recommendations on organizational, surgical, anaesthetic, and haemostatic strategies that can be used to provide optimal peri-operative blood management, reduce, or avoid blood transfusions and ultimately improve patient outcomes.

Publisher

Springer Science and Business Media LLC

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