All anesthesiologists are confronted with patients who show bleeding disorders, whether congenital, acquired, or pharmacologically induced. Although many studies, meta-analyses, guidelines, and textbooks have been published on the subject, they mostly cover specific aspects or require a thorough knowledge of hemostasis. The goal of this book is to provide the anesthesiologist with an overview of hemostasis and the mechanisms underlying bleeding and coagulation in general and to assist in the understanding of specific coagulation disorders as they may occur in the various anesthesia subspecialties. It is hoped that, through the provision of practical information and tools, the book will help residents and trained anesthesiologists to manage one of the most frustrating challenges that they face: the bleeding patient. A full understanding of coagulation requires a lifelong career, and this book is not intended to replace the consulting hematologist, whose expert opinion should always be sought.
The available procoagulant blood products and drugs all have potentially dangerous side-effects; furthermore, in bleeding disorders pitfalls are frequent and a misdiagnosis can have potentially catastrophic consequences. The aim of the editors is thus instead to enhance the collaboration between the disciplines of Anesthesiology and Hematology.
Part I: Pre-operative haemostasis: Cell based coagulation model.- Laboratory testing of hemostasis.- Viscoelastic tests of hemostasis.- Point of care platelet function tests.- Hemostasis assessment and evaluation.- Hereditary coagulopathies.- Acquired coagulopathies.- Drug induced - Antiplatelet drugs.- Intravenous fluids and coagulation.- Split blood products.- Isolated coagulation products.- Pro-coagulant drugs.- Patient blood management. Part II: Per-operative haemostasis: In cardiac surgery.- In Hepatic Surgery.- In Pediatric Surgery.- In Obstetrics Surgery.- In Trauma.- In Neurosurgery.- In Orthopedic Surgery.- In Neuraxial and Peripheral Nerve blocks. Part III: Post-Operative: Intensive Care.- Anti-Coagulation. Part IV: Economic aspects and organization.