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  • 1 Országos Orvosi Rehabilitációs Intézet, Budapest, 1121 Szanatórium utca 19.
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Absztrakt:

A transzfúzió gyakorlata jelentősen változott az elmúlt két évtizedben. A meglévő anémia és a perioperatív szakban alkalmazott transzfúzió a betegek gyógyulási esélyét csökkentik. A vértakarékos betegellátás programját a vérzés nagy kockázatával járó elektív sebészeti műtétekhez dolgozták ki szerte a világban. A műtét előtt az anémia, az elégtelen vasraktárak és a hemosztázis zavarának kezelése, a beavatkozás okozta vérvesztés csökkentése a program legfontosabb elemei. A vértranszfúzió egy egységenként történő adásának gyakorlata, az intraoperatív vérmentés, és a masszív transzfúziós protokoll, tranexámsav használata, a gondos sebészi hemosztázis, az intraoperatív hypothermia, acidózis elkerülése a program ugyancsak kiemelkedően fontos részei. A jelenlegi ajánlások a megszorító vörösvérsejt-transzfúziós gyakorlatot javasolják a hemodinamikailag stabil sebészeti és belgyógyászati betegeknél, miszerint transzfúzió adása nem szükséges, ha a hemoglobinszint több mint 70–80 g/l. A restriktív transzfúziós gyakorlat megfelelő lehet a legtöbb, anémia tüneteit nem mutató betegnél, csökkenti a transzfúzió adásának kockázatát és nem befolyásolja hátrányosan a mortalitást és morbiditást.. A restriktív transzfúziós gyakorlat megfelelő lehet a legtöbb anémia tüneteit nem mutató betegnek, csökkenti a transzfúzió adásának kockázatát és nem befolyásolja a mortalitást és morbiditást. A vértakarékos betegellátás bevezetése csökkentette az intraoperatív vérvesztést, vérfelhasználást, kórházi kezelés idejét és javította a betegellátás eredményességét. A programot sikeresen vezették be számos európai, amerikai és ausztráliai kórházban. Nincs kétség afelől, hogy kívánatos lenne ez hazánkban is.

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