Updates in perioperative hemostasis in the pediatric surgical patient.

IF 2.3 3区医学 Q2 ANESTHESIOLOGY

Current Opinion in Anesthesiology Pub Date : 2025-06-01 Epub Date: 2025-04-10 DOI:10.1097/ACO.0000000000001499

Michael Richard Greenberg, Edmund Jooste, Natalia Diaz-Rodriguez

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引用次数: 0

Abstract

Purpose of review: Maintaining hemostasis in pediatric patients undergoing major surgery presents unique challenges for the anesthesiologist. This review presents the most recent updates on pediatric perioperative bleeding and hemostasis management.

Recent findings: Patient blood management (PBM) programs remain scarcely implemented, but recent evidence for restrictive transfusion thresholds and reduction in allogeneic blood products in the pediatric population is growing. Notable updates include support for pediatric PBM programs, restrictive transfusion thresholds, increased use of viscoelastic testing, safety and efficacy of whole blood, and management of coagulopathy in trauma.

Summary: PBM programs and their key components have gained traction in the pediatric population in recent years: treating preoperative anemia, optimizing coagulation, and tolerating physiologic anemia through restrictive transfusion thresholds. Further evidence in the pediatric population is needed to guide the anesthesiologist.

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儿科外科患者围手术期止血的最新进展。

综述的目的：在接受大手术的儿科患者中维持止血对麻醉师来说是一个独特的挑战。这篇综述介绍了儿科围手术期出血和止血管理的最新进展。最近的发现：患者血液管理（PBM）计划仍然很少实施，但最近的证据表明，限制输血阈值和减少同种异体血液制品在儿科人群中越来越多。值得注意的更新包括对儿科PBM项目的支持，限制性输血阈值，粘弹性试验的增加使用，全血的安全性和有效性，以及创伤后凝血功能障碍的管理。摘要：近年来，PBM项目及其关键组成部分在儿科人群中获得了牵引力：治疗术前贫血，优化凝血，通过限制性输血阈值耐受生理性贫血。需要儿科人群的进一步证据来指导麻醉师。

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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来源期刊

Current Opinion in Anesthesiology 医学-麻醉学

CiteScore

4.90

自引率

8.00%

发文量

207

审稿时长

12 months

期刊介绍： Published bimonthly and offering a unique and wide ranging perspective on the key developments in the field, each issue of Current Opinion in Anesthesiology features hand-picked review articles from our team of expert editors. With fifteen disciplines published across the year – including cardiovascular anesthesiology, neuroanesthesia and pain medicine – every issue also contains annotated references detailing the merits of the most important papers.