3
Anästhesiologie (Fach) / Patient Blood Management (Lektion)
- Treatment preoperative anemia - Erythropoietin alpha 40'000 U sc - Fe-Carboxymaltose 1000 mg iv - Vitamin B12 1mg sc - Folic acid 5mg po/d
- Medical Aspects Correct preoperative anemia --> Iron (iv) + EPO Reduce perioperative RBC loss- Surgical technique ↑- Cell salvage and re-transfusion- Acute normovolemic hemodilution- Coagulopathy ↓ (anti-fibrinolyt., fibrinogen, F XIII, PCC)- Low CVP, no hypertension, normothermia, Optimize anemia management- Tolerate low hemoglobin values (restrictive TT)--> Iron (iv) + EPO postoperatively- FiO2 ↑
- RBC Transfusionen Nur noch indiziert bei: - severe malaria- major trauma- major sugery in severely anemic patients