RESUMEN
Conditions leading to iron overload range from rare hereditary disorders to more common medical conditions associated with chronic blood transfusions. Iron overload has deleterious effects on various vital organs (eg, liver, heart, and endocrine glands). Serum ferritin (in conjunction with transferrin saturation) is the most widely used test to evaluate iron burden and to screen for iron overload. The management plan should be adjusted to account for iron overload and potential consequences of liver, heart, and other organ involvement.
Asunto(s)
Sobrecarga de Hierro/diagnóstico , Anestesia/métodos , Biomarcadores/sangre , Ferritinas/sangre , Humanos , Hierro/metabolismo , Sobrecarga de Hierro/complicaciones , Sobrecarga de Hierro/fisiopatología , Transferrina/metabolismoRESUMEN
The application of blood conservation strategies to minimise or avoid allogeneic blood transfusion is seen internationally as a desirable objective. Bloodless surgery is a relatively new practice that facilitates that goal. However, the concept is either poorly understood or evokes negative connotations. Bloodless surgery is a term that has evolved in the medical literature to refer to a peri-operative team approach to avoid allogeneic transfusion and improve patient outcomes. Starting as an advocacy in the early 1960s, it has now grown into a serious practice being embraced by internationally respected clinicians and institutions. Central to its success is a coordinated multidisciplinary approach. It encompasses the peri-operative period with surgeons, anaesthetists, haematologists, intensivists, pathologists, transfusion specialists, pharmacists, technicians, and operating room and ward nurses utilising combinations of the numerous blood conservation techniques and transfusion alternatives now available. A comprehensive monograph on the subject of bloodless surgery along with detailed coverage of risks and benefits of each modality (some modalities are discussed in more detail elsewhere in this issue) is beyond the scope of this article. Accordingly, a brief overview of the history, theory and practice of bloodless surgery is presented, along with the clinical and institutional management requirements.
