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Coexisting Cardiac and Hematologic Disorders.
Jordan E Goldhammer1, Benjamin A Kohl1
1Department of Anesthesiology, Sidney Kimmel Medical College, Thomas Jefferson University, 111 South 11th Street, Philadelphia, PA 19107, USA.
Anesthesiology Clinics
|November 7, 2016
Summary
Managing anemia and anticoagulation in cardiac patients undergoing surgery requires careful planning. Optimize transfusion strategies and understand anticoagulation risks for better patient outcomes.
Area of Science:
- Cardiology
- Hematology
- Anesthesiology
Background:
- Managing patients with both cardiac and hematologic disorders for noncardiac surgery presents significant challenges.
- Anemia in patients with cardiac disease requires a systematic approach, focusing on individualized transfusion triggers and targets based on symptoms.
Purpose of the Study:
- To discuss common cardiac and hematologic disorders in patients undergoing noncardiac surgery.
- To outline strategies for optimizing the care of patients with coexisting cardiac and hematologic conditions.
Main Methods:
- Review of common hematologic disorders (e.g., anemia) in cardiac patients.
- Analysis of anticoagulation management strategies for patients with artificial heart valves, cardiac devices, or heart failure.
- Risk assessment for altering anticoagulation regimens in the perioperative setting.
Main Results:
- Transfusion decisions for anemic cardiac patients should be guided by symptomatology.
- Anticoagulation management requires a thorough understanding of the therapy's rationale and the risks associated with changes.
Conclusions:
- A methodical approach is crucial for managing anemia in cardiac patients.
- Comprehensive understanding of anticoagulation therapy and associated risks is essential for perioperative care in complex patients.
Keywords:
Anticoagulation management of severe heart failureCardiac manifestations of sickle cell diseaseEssential thrombocytosisIdiopathic thrombotic purpuraPerioperative anticoagulation management of artificial heart valvesPerioperative anticoagulation management of ventricular assist devicesPerioperative transfusion threshold
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