Bleeding perioperative bleeding monitoring of coagulation status and platelet function

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

2013 ESA Guidelines for the Management of Severe Perioperative Bleeding (DO NOT EDIT)[1]

2013 ESA Guidelines for the Management of Severe Perioperative Bleeding (DO NOT EDIT)^[1]

Class 1
“1. We recommend the use of a structured patient interview or questionnaire before surgery or invasive procedures, which considers clinical and family bleeding history and detailed information on the patient’s medication. (Level of Evidence: C) ”
“2. We recommend the use of standardized questionnaires on bleeding and drug history as preferable to the routine use of conventional coagulation screening tests such as aPTT, PT and platelet count in elective surgery. (Level of Evidence: C) ”
“3. We recommend the application of transfusion algorithms incorporating predefined intervention triggers to guide hemostatic intervention during intraoperative bleeding. (Level of Evidence: B) ”
“4. We recommend the application of transfusion algorithms incorporating predefined intervention triggers based on point-of-care (POC) coagulation monitoring assays to guide hemostatic intervention during cardiovascular surgery. (Level of Evidence: C) ”

Class 2
“1. We suggest preoperative platelet function testing only in addition to a positive bleeding anamnesis. (Level of Evidence: C) ”
“2. We suggest that preoperative platelet function testing be used to identify decreased platelet function caused by medical conditions and antiplatelet medication. (Level of Evidence: C) ”

Sources

References

↑ ^1.0 ^1.1 Kozek-Langenecker, SA.; Afshari, A.; Albaladejo, P.; Santullano, CA.; De Robertis, E.; Filipescu, DC.; Fries, D.; Görlinger, K.; Haas, T. (2013). “Management of severe perioperative bleeding: guidelines from the European Society of Anaesthesiology”. Eur J Anaesthesiol. 30 (6): 270–382. doi:10.1097/EJA.0b013e32835f4d5b. PMID 23656742. Unknown parameter |month= ignored (help)