Zusammenfassung
Die Transfusion von allogenen Blutprodukten ist mit einer Erhöhung der perioperativen Morbidität und Letalität assoziiert. Störungen der Hämostase sind insbesondere bei kardiochirurgischen Patienten häufig anzutreffen und können zu transfusionspflichtigen Blutungen führen. Eine zielgerichtete Therapie der häufig komplexen Gerinnungsstörungen erfordert eine differenzierte Diagnostik.
Abstract
The transfusion of allogeneic blood products is associated with increased morbidity and mortality. An impaired hemostasis is frequently found in patients undergoing cardiac surgery and may in turn cause bleeding and transfusions. A goal directed coagulation management addressing the often complex coagulation disorders needs sophisticated diagnostics. This may improve both patientsʼ outcome and costs. Recent data suggest that coagulation management based on a rational algorithm is more effective than traditional therapy based on conventional laboratory variables such as PT and INR. Platelet inhibitors, cumarins, direct oral anticoagulants and heparin need different diagnostic and therapeutic approaches. An algorithm specifically developed for use during cardiac surgery is presented.
Schlüsselwörter
Gerinnung - Herzchirurgie - Algorithmus - Kardioanästhesie - Antikoagulanzien
Key words
Coagulation - cardiac surgery - algorithm - cardiac anaesthesia - anticoagulants
