TY - JOUR
T1 - Management of severe perioperative bleeding
T2 - Guidelines from the European Society of Anaesthesiology
AU - Kozek-Langenecker, Sibylle A.
AU - Afshari, Arash
AU - Albaladejo, Pierre
AU - Santullano, Cesar Aldecoa Alvarez
AU - De Robertis, Edoardo
AU - Filipescu, Daniela C.
AU - Fries, Dietmar
AU - Görlinger, Klaus
AU - Haas, Thorsten
AU - Imberger, Georgina
AU - Jacob, Matthias
AU - Lancé, Marcus
AU - Llau, Juan
AU - Mallett, Sue
AU - Meier, Jens
AU - Rahe-Meyer, Niels
AU - Samama, Charles Marc
AU - Smith, Andrew
AU - Solomon, Cristina
AU - Van Der Linden, Philippe
AU - Wikkelsø, Anne Juul
AU - Wouters, Patrick
AU - Wyffels, Piet
PY - 2013/6
Y1 - 2013/6
N2 - The aims of severe perioperative bleeding management are three-fold. First, preoperative identification by anamesis and laboratory testing of those patients for whom the perioperative bleeding risk may be increased. Second, implementation of strategies for correcting preoperative anaemia and stabilisation of the macro- and microcirculations in order to optimise the patient's tolerance to bleeding. Third, targeted procoagulant interventions to reduce the amount of bleeding, morbidity, mortality and costs. The purpose of these guidelines is to provide an overview of current knowledge on the subject with an assessment of the quality of the evidence in order to allow anaesthetists throughout Europe to integrate this knowledge into daily patient care wherever possible. The Guidelines Committee of the European Society of Anaesthesiology (ESA) formed a task force with members of scientific subcommittees and individual expert members of the ESA. Electronic databases were searched without language restrictions from the year 2000 until 2012. These searches produced 20 664 abstracts. Relevant systematic reviews with meta-analyses, randomised controlled trials, cohort studies, case-control studies and cross-sectional surveys were selected. At the suggestion of the ESA Guideline Committee, the Scottish Intercollegiate Guidelines Network (SIGN) grading system was initially used to assess the level of evidence and to grade recommendations. During the process of guideline development, the official position of the ESA changed to favour the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. This report includes general recommendations as well as specific recommendations in various fields of surgical interventions. The final draft guideline was posted on the ESA website for four weeks and the link was sent to all ESA members. Comments were collated and the guidelines amended as appropriate. When the final draft was complete, the Guidelines Committee and ESA Board ratified the guidelines.
AB - The aims of severe perioperative bleeding management are three-fold. First, preoperative identification by anamesis and laboratory testing of those patients for whom the perioperative bleeding risk may be increased. Second, implementation of strategies for correcting preoperative anaemia and stabilisation of the macro- and microcirculations in order to optimise the patient's tolerance to bleeding. Third, targeted procoagulant interventions to reduce the amount of bleeding, morbidity, mortality and costs. The purpose of these guidelines is to provide an overview of current knowledge on the subject with an assessment of the quality of the evidence in order to allow anaesthetists throughout Europe to integrate this knowledge into daily patient care wherever possible. The Guidelines Committee of the European Society of Anaesthesiology (ESA) formed a task force with members of scientific subcommittees and individual expert members of the ESA. Electronic databases were searched without language restrictions from the year 2000 until 2012. These searches produced 20 664 abstracts. Relevant systematic reviews with meta-analyses, randomised controlled trials, cohort studies, case-control studies and cross-sectional surveys were selected. At the suggestion of the ESA Guideline Committee, the Scottish Intercollegiate Guidelines Network (SIGN) grading system was initially used to assess the level of evidence and to grade recommendations. During the process of guideline development, the official position of the ESA changed to favour the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. This report includes general recommendations as well as specific recommendations in various fields of surgical interventions. The final draft guideline was posted on the ESA website for four weeks and the link was sent to all ESA members. Comments were collated and the guidelines amended as appropriate. When the final draft was complete, the Guidelines Committee and ESA Board ratified the guidelines.
UR - http://www.scopus.com/inward/record.url?scp=84879173771&partnerID=8YFLogxK
U2 - 10.1097/EJA.0b013e32835f4d5b
DO - 10.1097/EJA.0b013e32835f4d5b
M3 - Article
C2 - 23656742
AN - SCOPUS:84879173771
SN - 0265-0215
VL - 30
SP - 270
EP - 382
JO - European Journal of Anaesthesiology
JF - European Journal of Anaesthesiology
IS - 6
ER -