Management of severe perioperative bleeding: Guidelines from the European Society of Anaesthesiology

Sibylle A. Kozek-Langenecker, Aamer B. Ahmed, Arash Afshari, Pierre Albaladejo, Cesar Aldecoa, Guidrius Barauskas, Edoardo De Robertis, David Faraoni, Daniela C. Filipescu, Dietmar Fries, Haas Thorsten, Matthias Jacob, Marcus D. Lancé, Juan V.L. Pitarch, Susan Mallett, Jens Meier, Zsolt L. Molnar, Niels Rahe-Meyer, Charles M. Samama, Jakob StensballePhilippe J.F. Van Der Linden, Anne J. Wikkelsø, Patrick Wouters, Piet Wyffels, Kai Zacharowski

Research output: Contribution to journalReview articlepeer-review

616 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)332-395
Number of pages64
JournalEuropean Journal of Anaesthesiology
Issue number6
Publication statusPublished - 1 Jun 2017
Externally publishedYes


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