Revisión crítica 2024 de las recomendaciones de gestión de sangre de los pacientes sometidos a cirugía mayor en la vía rica

IF 1.3 4区医学 Q3 SURGERY Cirugia Espanola Pub Date : 2025-02-01 DOI:10.1016/j.ciresp.2024.10.011

Vicky Moral , Carlos Jericó , Ane Abad Motos , José Antonio Páramo , Manuel Quintana Díaz , José Antonio García Erce , en representación del grupo asesor y revisor externo de las recomendaciones PBM de la vía RICA 2021

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Abstract

The Spanish enhanced recovery in adult surgery strategy, the “RICA pathway”, was published in 2021 and includes 19 specific recommendations and more than 20 indirect recommendations for patient blood management (PBM).

After reviewing these recommendations, and in the context of the new clinical evidence available, we propose the following updates:

- First: Detection and treatment of any preoperative anemia status in ALL patients who are candidates for major surgery with hematinic deficiencies.

- Second: Universal use of tranexamic acid in major surgery, bedside monitoring of intraoperative hemoglobin levels, restrictive transfusion criteria, and monitoring of patient well-being in terms of hydration, coagulability, normothermia and analgesia.

- Third: Restrictive transfusion criteria, single-unit blood transfusion and diagnosis/treatment of postoperative anemia.

Real, universal implementation and integration of PBM in the RICA program is urgently needed.

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《2024年大手术患者血液管理建议的关键审查》

西班牙成人手术增强康复策略“RICA路径”于2021年发布，其中包括19项具体建议和20多项针对患者血液管理（PBM）的间接建议。在回顾了这些建议，并在新的临床证据的背景下，我们提出以下更新：-第一：检测和治疗任何术前贫血状态的所有患者，他们是大手术候选人与血液缺陷。-第二：在大手术中普遍使用氨甲环酸，床边监测术中血红蛋白水平，限制性输血标准，监测患者在水合、凝血、体温和镇痛方面的健康状况。-第三：限制性输血标准、单单位输血和术后贫血的诊断/治疗。迫切需要在RICA项目中真正、普遍地实施和整合PBM。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cirugia Espanola SURGERY-

CiteScore

1.20

自引率

21.10%

发文量

173

审稿时长

53 days

期刊介绍： Cirugía Española, an official body of the Asociación Española de Cirujanos (Spanish Association of Surgeons), will consider original articles, reviews, editorials, special articles, scientific letters, letters to the editor, and medical images for publication; all of these will be submitted to an anonymous external peer review process. There is also the possibility of accepting book reviews of recent publications related to General and Digestive Surgery.