P. Hurtado , M. Garcia-Orellana , A. Martinez-Simon , G. Pujol-Fontrodona , E. Méndez , P. Doménech-Asensi , A. Pajares , A. López-Gómez , L. Valencia , M.J. Colomina , J. Fernández-Candil , Grupo de trabajo de Neurociencias y Hemostasia, Medicina Transfusional y Fluidoterapia de la Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor (SEDAR)
{"title":"颅切开术术后输血管理:全国调查,评估护理改善情况的起点","authors":"P. Hurtado , M. Garcia-Orellana , A. Martinez-Simon , G. Pujol-Fontrodona , E. Méndez , P. Doménech-Asensi , A. Pajares , A. López-Gómez , L. Valencia , M.J. Colomina , J. Fernández-Candil , Grupo de trabajo de Neurociencias y Hemostasia, Medicina Transfusional y Fluidoterapia de la Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor (SEDAR)","doi":"10.1016/j.redar.2024.501661","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To assess the perioperative management of haemostasis and transfusion practices in adult patients undergoing craniotomies.</div></div><div><h3>Method</h3><div>Online questionnaire addressed to Spanish anaesthesiologists and promoted by the Neurosciences and Haemostasis, Transfusion Medicine and Fluid Therapy Sections of SEDAR. The questionnaire was sent by email and social media, and was active between June and October 2022.</div></div><div><h3>Results</h3><div>We obtained 155 responses from 67 centres; 59.4% perform >100 craniotomies per year. 61.7% were regularly involved in neuroanaesthesiology. Only 21.9% of respondents had pre-anaesthesia assessment performed by a member of that section, and in most of them (83.0%) the assessment was performed ≤3 weeks in advance. Of the respondents with Patient Blood Management programmes, 58.2% had no specific protocols for craniotomies. 90.3% reported that haemoconcentrates are systematically reserved. A lower platelet limit of 100,000/mcL is considered acceptable by 76.8%. 99.4% of respondents discontinued antiplatelet medication based on half-life. Only 23.9% respondents routinely discontinued non-steroidal anti-inflammatory drugs. The transfusion threshold for haemoglobin during surgical bleeding was <10g/dl in 18.7%, <9g/dl in 38.1%, <8g/dl in 38.7% and <7 g/dl in 4.5%.</div></div><div><h3>Conclusions</h3><div>Preoperative anaemia screening and treatment programmes are not implemented and blood product reserves are systematised in patients scheduled for craniotomy. Anti-aggregation therapy is discontinued according to the half-life of the drug without checking platelet functionality.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 3","pages":"Article 501661"},"PeriodicalIF":0.9000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Manejo transfusional perioperatorio en craneotomías: encuesta nacional, un punto de partida para valorar la mejora asistencial\",\"authors\":\"P. Hurtado , M. Garcia-Orellana , A. Martinez-Simon , G. Pujol-Fontrodona , E. Méndez , P. Doménech-Asensi , A. Pajares , A. López-Gómez , L. Valencia , M.J. Colomina , J. Fernández-Candil , Grupo de trabajo de Neurociencias y Hemostasia, Medicina Transfusional y Fluidoterapia de la Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor (SEDAR)\",\"doi\":\"10.1016/j.redar.2024.501661\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>To assess the perioperative management of haemostasis and transfusion practices in adult patients undergoing craniotomies.</div></div><div><h3>Method</h3><div>Online questionnaire addressed to Spanish anaesthesiologists and promoted by the Neurosciences and Haemostasis, Transfusion Medicine and Fluid Therapy Sections of SEDAR. The questionnaire was sent by email and social media, and was active between June and October 2022.</div></div><div><h3>Results</h3><div>We obtained 155 responses from 67 centres; 59.4% perform >100 craniotomies per year. 61.7% were regularly involved in neuroanaesthesiology. Only 21.9% of respondents had pre-anaesthesia assessment performed by a member of that section, and in most of them (83.0%) the assessment was performed ≤3 weeks in advance. Of the respondents with Patient Blood Management programmes, 58.2% had no specific protocols for craniotomies. 90.3% reported that haemoconcentrates are systematically reserved. A lower platelet limit of 100,000/mcL is considered acceptable by 76.8%. 99.4% of respondents discontinued antiplatelet medication based on half-life. Only 23.9% respondents routinely discontinued non-steroidal anti-inflammatory drugs. The transfusion threshold for haemoglobin during surgical bleeding was <10g/dl in 18.7%, <9g/dl in 38.1%, <8g/dl in 38.7% and <7 g/dl in 4.5%.</div></div><div><h3>Conclusions</h3><div>Preoperative anaemia screening and treatment programmes are not implemented and blood product reserves are systematised in patients scheduled for craniotomy. Anti-aggregation therapy is discontinued according to the half-life of the drug without checking platelet functionality.</div></div>\",\"PeriodicalId\":46479,\"journal\":{\"name\":\"Revista Espanola de Anestesiologia y Reanimacion\",\"volume\":\"72 3\",\"pages\":\"Article 501661\"},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Revista Espanola de Anestesiologia y Reanimacion\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0034935624001403\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista Espanola de Anestesiologia y Reanimacion","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0034935624001403","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
Manejo transfusional perioperatorio en craneotomías: encuesta nacional, un punto de partida para valorar la mejora asistencial
Objective
To assess the perioperative management of haemostasis and transfusion practices in adult patients undergoing craniotomies.
Method
Online questionnaire addressed to Spanish anaesthesiologists and promoted by the Neurosciences and Haemostasis, Transfusion Medicine and Fluid Therapy Sections of SEDAR. The questionnaire was sent by email and social media, and was active between June and October 2022.
Results
We obtained 155 responses from 67 centres; 59.4% perform >100 craniotomies per year. 61.7% were regularly involved in neuroanaesthesiology. Only 21.9% of respondents had pre-anaesthesia assessment performed by a member of that section, and in most of them (83.0%) the assessment was performed ≤3 weeks in advance. Of the respondents with Patient Blood Management programmes, 58.2% had no specific protocols for craniotomies. 90.3% reported that haemoconcentrates are systematically reserved. A lower platelet limit of 100,000/mcL is considered acceptable by 76.8%. 99.4% of respondents discontinued antiplatelet medication based on half-life. Only 23.9% respondents routinely discontinued non-steroidal anti-inflammatory drugs. The transfusion threshold for haemoglobin during surgical bleeding was <10g/dl in 18.7%, <9g/dl in 38.1%, <8g/dl in 38.7% and <7 g/dl in 4.5%.
Conclusions
Preoperative anaemia screening and treatment programmes are not implemented and blood product reserves are systematised in patients scheduled for craniotomy. Anti-aggregation therapy is discontinued according to the half-life of the drug without checking platelet functionality.