Protocol for postpartum haemorrhage including massive transfusion

IF 2.8 3区 医学 Q1 ANESTHESIOLOGY
Ove Karlsson MD, PhD (Consultant Anaesthetist)
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引用次数: 1

Abstract

Postpartum haemorrhage (PPH) is one of the most common causes of maternal mortality worldwide. Management of PPH depends on the severity of bleeding. If the bleeding is severe, aorta compression can reduce bleeding. It should be followed by insertion of two coarse needles for intravenous access and blood sampling for haemoglobin and haemostasis. Further on, monitoring of vital parameters, as well as provision of extra oxygen and warm crystalloids, should be performed. Uterine atony is the most common cause of PPH and local guidelines for uterotonic drug selection should be followed. Patients with ongoing bleeding should immediately receive surgical care for bleeding control. During severe ongoing bleeding, haemostasis care includes early tranexamic acid, transfusion in ratio 4:4:1 (blood:plasma:platelets), and extra fibrinogen intravenously. If not severe PPH, use goal-directed therapy. During general anaesthesia and uterine atony, stop volatile anaesthesia and change to intravenous anaesthesia.

产后出血的治疗方案包括大量输血
产后出血(PPH)是全世界孕产妇死亡的最常见原因之一。PPH的治疗取决于出血的严重程度。如果出血严重,压缩主动脉可以减少出血。随后应插入两根粗针进行静脉注射,并采血检查血红蛋白和止血情况。此外,还应监测重要参数,并提供额外的氧气和温暖的晶体。子宫张力是PPH最常见的原因,应遵循当地子宫张力药物选择指南。持续出血的患者应立即接受手术治疗以控制出血。在严重持续出血时,止血护理包括早期氨甲环酸,以4:4:1的比例(血液:血浆:血小板)输血,以及静脉注射额外的纤维蛋白原。如果不是严重的PPH,使用目标导向治疗。在全身麻醉和子宫弛缓期间,停止挥发性麻醉,改为静脉麻醉。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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审稿时长
36 days
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