World Journal of Emergency Surgery (Jul 2024)
Strategies to prevent blood loss and reduce transfusion in emergency general surgery, WSES-AAST consensus paper
- Federico Coccolini,
- Aryeh Shander,
- Marco Ceresoli,
- Ernest Moore,
- Brian Tian,
- Dario Parini,
- Massimo Sartelli,
- Boris Sakakushev,
- Krstina Doklestich,
- Fikri Abu-Zidan,
- Tal Horer,
- Vishal Shelat,
- Timothy Hardcastle,
- Elena Bignami,
- Andrew Kirkpatrick,
- Dieter Weber,
- Igor Kryvoruchko,
- Ari Leppaniemi,
- Edward Tan,
- Boris Kessel,
- Arda Isik,
- Camilla Cremonini,
- Francesco Forfori,
- Lorenzo Ghiadoni,
- Massimo Chiarugi,
- Chad Ball,
- Pablo Ottolino,
- Andreas Hecker,
- Diego Mariani,
- Ettore Melai,
- Manu Malbrain,
- Vanessa Agostini,
- Mauro Podda,
- Edoardo Picetti,
- Yoram Kluger,
- Sandro Rizoli,
- Andrey Litvin,
- Ron Maier,
- Solomon Gurmu Beka,
- Belinda De Simone,
- Miklosh Bala,
- Aleix Martinez Perez,
- Carlos Ordonez,
- Zenon Bodnaruk,
- Yunfeng Cui,
- Augusto Perez Calatayud,
- Nicola de Angelis,
- Francesco Amico,
- Emmanouil Pikoulis,
- Dimitris Damaskos,
- Raul Coimbra,
- Mircea Chirica,
- Walter L. Biffl,
- Fausto Catena
Affiliations
- Federico Coccolini
- General Emergency and Trauma Surgery Department, Pisa University Hospital
- Aryeh Shander
- Anesthesiology and Critical Care, Rutgers University
- Marco Ceresoli
- General Emergency and Trauma Surgery Department, Monza University Hospital
- Ernest Moore
- Ernest E. Moore Shock Trauma Center, University of Colorado
- Brian Tian
- General Emergency and Trauma Surgery Department, Cesena Hospital
- Dario Parini
- General Surgery Department, Rovigo Hospital
- Massimo Sartelli
- General Surgery Department, Macerata Hospital
- Boris Sakakushev
- General Surgery Department, University Hospital St George, Medical University
- Krstina Doklestich
- Clinic of Emergency Surgery, University Clinical Center of Serbia
- Fikri Abu-Zidan
- The Research Office, College of Medicine and Health Sciences, United Arab Emirates University
- Tal Horer
- Vascular and Trauma Surgery, Orebro Hospital
- Vishal Shelat
- Department of General Surgery, Tan Tock Seng Hospital
- Timothy Hardcastle
- Department of Trauma and Burns, Inkosi Albert Luthuli Central Hospital and Department of Surgical Sciences, University of KwaZulu-Natal
- Elena Bignami
- Anesthesia Department, Parma University Hospital
- Andrew Kirkpatrick
- General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery Foothills Medical Centre
- Dieter Weber
- Department of General Surgery, Royal Perth Hospital
- Igor Kryvoruchko
- Department of Surgery No. 2, Kharkiv National Medical University
- Ari Leppaniemi
- General Surgery Department, Melahiti Hospital
- Edward Tan
- Emergency Surgery Department, Radboud Medical Centre
- Boris Kessel
- Hillel Yaffe Medical Center, Rappaport Medical School
- Arda Isik
- Division of General Surgery, School of Medicine, Istanbul Medeniyet University
- Camilla Cremonini
- General Emergency and Trauma Surgery Department, Pisa University Hospital
- Francesco Forfori
- ICU Department, Pisa University Hospital
- Lorenzo Ghiadoni
- Emergency Medicine Department, Pisa University Hospital
- Massimo Chiarugi
- General Emergency and Trauma Surgery Department, Pisa University Hospital
- Chad Ball
- Trauma and Acute Care Surgery, Foothills Medical Center
- Pablo Ottolino
- Unidad de Trauma y Urgencias, Hospital Dr. Sótero del Río
- Andreas Hecker
- Department of General, Thoracic and Transplant Surgery, University Hospital of Giessen
- Diego Mariani
- General Surgery Department, Legnano Hospital
- Ettore Melai
- ICU Department, Pisa University Hospital
- Manu Malbrain
- First Department of Anesthesiology and Intensive Therapy, Medical University of Lublin
- Vanessa Agostini
- Medicina Trasfusionale, IRCCS-Ospedale Policlinico San Martino
- Mauro Podda
- Department of Surgical Science, University of Cagliari
- Edoardo Picetti
- Department of Anesthesia and Intensive Care, Parma University Hospital
- Yoram Kluger
- General, Emergency and Trauma Surgery Department, Rambam Medical Centre
- Sandro Rizoli
- Trauma Surgery, Hamad General Hospital
- Andrey Litvin
- Department of Surgical Diseases No. 3, University Clinic, Gomel State Medical University
- Ron Maier
- Harborview Medical Center, University of Washington
- Solomon Gurmu Beka
- Emergency Surgery, Ethiopian Air Force
- Belinda De Simone
- Department of Digestive and Emergency Surgery, Infermi Hospital
- Miklosh Bala
- Trauma and Acute Care Surgery Unit Department of General Surgery, Hadassah Medical Center
- Aleix Martinez Perez
- Faculty of Health Sciences, Valencian International University (VIU)
- Carlos Ordonez
- Division of Trauma and Acute Care Surgery, Department of Surgery, Fundación Valle del Lili
- Zenon Bodnaruk
- Hospital Information Services for Jehovah’s Witnesses
- Yunfeng Cui
- Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University
- Augusto Perez Calatayud
- Critical Care Division Hospital General de México Dr Eduardo Liceaga
- Nicola de Angelis
- General Surgery Department, Ferrara University Hospital
- Francesco Amico
- Discipline of Surgery, The University of Newcastle
- Emmanouil Pikoulis
- 3rd Department of Surgery, Attikon General Hospital, National and Kapodistrian University of Athens (NKUA)
- Dimitris Damaskos
- General Surgery Department, Edinburgh Hospital
- Raul Coimbra
- General Surgery Department, Riverside University Health System Medical Center
- Mircea Chirica
- General Surgery Department, Grenoble University Hospital
- Walter L. Biffl
- Division of Trauma/Acute Care Surgery, Scripps Clinic Medical Group
- Fausto Catena
- General Emergency and Trauma Surgery Department, Cesena Hospital
- DOI
- https://doi.org/10.1186/s13017-024-00554-7
- Journal volume & issue
-
Vol. 19,
no. 1
pp. 1 – 18
Abstract
Abstract Emergency general surgeons often provide care to severely ill patients requiring surgical interventions and intensive support. One of the primary drivers of morbidity and mortality is perioperative bleeding. In general, when addressing life threatening haemorrhage, blood transfusion can become an essential part of overall resuscitation. However, under all circumstances, indications for blood transfusion must be accurately evaluated. When patients decline blood transfusions, regardless of the reason, surgeons should aim to provide optimal care and respect and accommodate each patient’s values and target the best outcome possible given the patient’s desires and his/her clinical condition. The aim of this position paper was to perform a review of the existing literature and to provide comprehensive recommendations on organizational, surgical, anaesthetic, and haemostatic strategies that can be used to provide optimal peri-operative blood management, reduce, or avoid blood transfusions and ultimately improve patient outcomes.
Keywords
