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Cardiac Anesthesia in Infants and Children: Postoperative Bleeding and Coagulation Management
- Source :
- Congenital Heart Disease in Pediatric and Adult Patients ISBN: 9783031104411, Congenital Heart Disease in Pediatric and Adult Patients ISBN: 9783319446899
- Publication Year :
- 2023
- Publisher :
- Springer International Publishing, 2023.
-
Abstract
- Postoperative bleeding is the most common complication after pediatric cardiac surgery. Up to 5 % of cardiac surgery will require re-exploration for major blood loss in the first 24 h after surgery. Uncontrolled bleeding if not addressed early could lead to hypovolemic shock, multi-organ failure, and eventually death. Concealed bleeding in the chest could also cause cardiac tamponade if the chest and mediastinum are not adequately drained. Blood product use is not devoid of complication, and strategies should be designed to minimize transfusion as much as possible. There are several known medical and surgical risk factors for postoperative bleeding. During the preoperative visit, the anesthesiologist should investigate for “red flags” for postoperative bleeding and address them. Unnecessary medications that could affect coagulation should be discontinued. Medical conditions that affected the coagulation system should be stabilized. Cardiopulmonary bypass (CPB) strategies and surgical plan should also consider the effect on bleeding and coagulation. Finally it is very important to plan for adequate intravenous access and use of prophylactic agents and to secure availability of blood, coagulation factors, and components.
- Subjects :
- medicine.medical_specialty
business.industry
medicine.medical_treatment
Mediastinum
medicine.disease
Prothrombin complex concentrate
Surgery
law.invention
Cardiac surgery
medicine.anatomical_structure
law
Shock (circulatory)
Anesthesia
Cardiac tamponade
Ventricular assist device
medicine
Cardiopulmonary bypass
medicine.symptom
Complication
business
medicine.drug
Subjects
Details
- ISBN :
- 978-3-031-10441-1
978-3-319-44689-9 - ISBNs :
- 9783031104411 and 9783319446899
- Database :
- OpenAIRE
- Journal :
- Congenital Heart Disease in Pediatric and Adult Patients ISBN: 9783031104411, Congenital Heart Disease in Pediatric and Adult Patients ISBN: 9783319446899
- Accession number :
- edsair.doi.dedup.....329e4f22a49a47b2ebb32b0d079df97b