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Current Anesthesiology Reports
Erschienen in: Current Anesthesiology Reports 2/2020

23.03.2020 | Blood Management (KA Tanaka, Section Editor)

Blood Conservation for Complex Spine and Intracranial Procedures

verfasst von: Kamilla Esfahani, Lauren K. Dunn, Bhiken I. Naik

Erschienen in: Current Anesthesiology Reports | Ausgabe 2/2020

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Abstract

Purpose of Review

Neurological surgery, which includes intracranial and spine surgery, is associated with a significant risk of major perioperative bleeding. This review highlights the various blood conservation techniques currently in practice for major, complex spine and intracranial surgery.

Recent Findings

Several techniques have been described to reduce blood loss and transfusion requirements perioperatively. These include preoperative risk identification and stratification and use of different blood conservation strategies perioperatively. The efficacy and safety of tranexamic acid has been demonstrated in major spine surgery, and its role has expanded in traumatic brain injury based on the CRASH-3 study. Permissive hypotension should be avoided based on recent high-quality observational data on the negative effects of cumulative hypotension on end-organ injury. The use of viscoelastic blood coagulation management is increasingly used as a theragnostic approach to blood conservation strategies.

Summary

The ability to minimize blood loss and reduce exposure to allogeneic blood transfusions, which can greatly increase perioperative morbidity and mortality, is paramount. Our review provides a framework for evidence-based blood conservation strategies for neurological surgery.
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Metadaten
Titel
Blood Conservation for Complex Spine and Intracranial Procedures
verfasst von
Kamilla Esfahani
Lauren K. Dunn
Bhiken I. Naik
Publikationsdatum
23.03.2020
Verlag
Springer US
Erschienen in
Current Anesthesiology Reports / Ausgabe 2/2020
Elektronische ISSN: 2167-6275
DOI
https://doi.org/10.1007/s40140-020-00383-9

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