在外科手术期间的儿科患者血液管理:叙述性综述
Susan M Goobie1, David Faraoni2
1Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
British journal of anaesthesia
|October 25, 2024
概括
患者血液管理 (PBM) 通过治疗贫血和出血来改善护理. 儿科PBM虽然具有挑战性,但为手术患者提供了显著的好处.
科学领域:
- * 麻醉学和外科手术期间医学
- * 血液学和输血医学
背景情况:
- *患者血液管理 (PBM) 是一种基于证据的多模式方法,通过管理贫血,凝血病和失血来优化患者的治疗结果.
- *虽然建议成人使用,但由于数据有限和独特的生理挑战,PBM尚未成为儿童群体的标准护理.
- * 儿科PBM需要根据新生儿,婴儿,儿童和青少年的年龄,体重和生理学量身定制的策略.
研究的目的:
- * 审查儿童手术群体中PBM的最新更新,益处和原则.
- * 概述专家共识的指导方针和多模式治疗策略,用于治疗儿科贫血,出血和凝血病.
- * 为儿童患者突出实际的术后PBM策略.
主要方法:
- * 本叙事综述综合了有关儿科患者血液管理的当前文献和专家共识.
- *专注于多模式策略,包括手术前贫血治疗,限制性输血门,抗纤维解毒剂,细胞挽救和目标导向治疗.
- *强调使用点治疗和粘弹性测试来做出明智的临床决策.
主要成果:
- * 儿科PBM对于改善手术环境中的临床护理和患者结果至关重要.
- *多式PBM策略在治疗贫血和尽量减少儿童出血方面是有效的.
- * 特定的PBM干预可以优化贫血,出血或凝血病的儿科患者的术后管理.
结论:
- * 儿科患者的血液管理对于优化手术群体的护理至关重要.
- * 实施基于证据的PBM策略可以显著改善结果,并减少儿童的输血需求.
- * 建议进一步研究和采用PBM,以将其作为儿科患者的护理标准.
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