Perioperative Patient Blood Management（PBM）by Anesthesiologists - Focus on the Practical Approach in the Operating Room -

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  • KIKURA Mutsuhito
    Department of Anesthesiology, Hamamatsu Rosai Hospital, Japan Organization of Occupational Health and Safety
  • URAOKA Masahiro
    Department of Anesthesiology, Hamamatsu Rosai Hospital, Japan Organization of Occupational Health and Safety
  • NISHINO Junko
    Department of Anesthesiology, Hamamatsu Rosai Hospital, Japan Organization of Occupational Health and Safety

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  • 麻酔科医が考え，実践するPBM（patient blood management）─臨床現場での取り組みを中心に─

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Abstract

<p>On entering the 21st century, coagulation management that includes fibrinogen has increasingly been regarded as important. Japanese antifibrinolytic therapy has contributed to reduction in blood transfusion around the world. Although there are many reports of blood transfusion reduction by the blood transfusion algorithm in cardiovascular surgery, there have been few in general surgery. In general surgery, the need for fresh frozen plasma is related more to a reduction of fibrinogen than the amount of bleeding. To reduce unnecessary blood transfusions, we have developed clinical simulation systems to predict reduction of fibrinogen according to bleeding volume, and we have stratified a starting amount of fresh frozen plasma near the trigger level（130 mg/dL）. In emergencies, the “dry hematology” method is useful for measuring fibrinogen（5 minutes）. It is very important to feedback the information obtained from clinical reports and studies toward patient blood management.</p>

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