Fuente; http://www.anestesia-dolor.org/repositorio/a_subespecialidades-ortopedia.html
Detección, evaluación y manejo de la anemia preoperatoria en los pacientes ortopédicos quirúrgicos electivos: Guía NATA
Detección, evaluación y manejo de la anemia preoperatoria en los pacientes ortopédicos quirúrgicos electivos: Guía NATA
http://bja.oxfordjournals.org/content/106/1/13.full.pdf
Summary. Previously undiagnosed anaemia is common in elective orthopaedic surgical
patients and is associated with increased likelihood of blood transfusion and increased
perioperative morbidity and mortality. A standardized approach for the detection,
evaluation, and management of anaemia in this setting has been identified as an unmet
medical need. A multidisciplinary panel of physicians was convened by the Network for
Advancement of Transfusion Alternatives (NATA) with the aim of developing practice
guidelines for the detection, evaluation, and management of preoperative anaemia in
elective orthopaedic surgery. A systematic literature review and critical evaluation of the
evidence was performed, and recommendations were formulated according to the
method proposed by the Grades of Recommendation Assessment, Development and
Evaluation (GRADE) Working Group. We recommend that elective orthopaedic surgical
patients have a haemoglobin (Hb) level determination 28 days before the scheduled
surgical procedure if possible (Grade 1C). We suggest that the patient’s target Hb before
elective surgery be within the normal range, according to the World Health Organization
criteria (Grade 2C). We recommend further laboratory testing to evaluate anaemia for
nutritional deficiencies, chronic renal insufficiency, and/or chronic inflammatory disease
(Grade 1C). We recommend that nutritional deficiencies be treated (Grade 1C). We
suggest that erythropoiesis-stimulating agents be used for anaemic patients in whom
nutritional deficiencies have been ruled out, corrected, or both (Grade 2A). Anaemia
should be viewed as a serious and treatable medical condition, rather than simply an
abnormal laboratory value. Implementation of anaemia management in the elective
orthopaedic surgery setting will improve patient outcomes.
Summary. Previously undiagnosed anaemia is common in elective orthopaedic surgical
patients and is associated with increased likelihood of blood transfusion and increased
perioperative morbidity and mortality. A standardized approach for the detection,
evaluation, and management of anaemia in this setting has been identified as an unmet
medical need. A multidisciplinary panel of physicians was convened by the Network for
Advancement of Transfusion Alternatives (NATA) with the aim of developing practice
guidelines for the detection, evaluation, and management of preoperative anaemia in
elective orthopaedic surgery. A systematic literature review and critical evaluation of the
evidence was performed, and recommendations were formulated according to the
method proposed by the Grades of Recommendation Assessment, Development and
Evaluation (GRADE) Working Group. We recommend that elective orthopaedic surgical
patients have a haemoglobin (Hb) level determination 28 days before the scheduled
surgical procedure if possible (Grade 1C). We suggest that the patient’s target Hb before
elective surgery be within the normal range, according to the World Health Organization
criteria (Grade 2C). We recommend further laboratory testing to evaluate anaemia for
nutritional deficiencies, chronic renal insufficiency, and/or chronic inflammatory disease
(Grade 1C). We recommend that nutritional deficiencies be treated (Grade 1C). We
suggest that erythropoiesis-stimulating agents be used for anaemic patients in whom
nutritional deficiencies have been ruled out, corrected, or both (Grade 2A). Anaemia
should be viewed as a serious and treatable medical condition, rather than simply an
abnormal laboratory value. Implementation of anaemia management in the elective
orthopaedic surgery setting will improve patient outcomes.
No hay comentarios:
Publicar un comentario