DerAnaesthesist.50440191.ger.abstr-passage-0
abstract
Aufgrund der Entwicklung der letzten Jahre wurde nicht nur die Indikationsstellung zur Transfusion homologer Blutprodukte neu ueberdacht , sondern Methoden zur Einsparung von Fremdblut sind zu einem Standard in der moderen perioperativen Medizin geworden . Ist bei elektiven Eingriffen mit groesseren Blutverlusten zu rechnen , so muss ueber die Notwendigkeit oder Wahrscheinlichkeit einer Bluttransfusion , ueber ihre typischen Riskiken sowie ueber die fremdblutsparenden Methoden aufgeklaert werden , wenn diese im konkreten Fall als Alternative zur homologen Transfusion in Betracht kommen . Basierend auf den tatsaechlichen , durch eine Hausstatistik erhobenen Verbrauch sollte fuer jeden Bereich ein individuelles Blutsparkonzept in interdisziplinaerer Zusammenarbeit zwischen Chirurgen , Anaesthesisten und Transfusionsmedizinern geschaffen werden . Die Anwendung der eigentlichen Blutspartechniken ist nur bei exakter , blutsparender Operationstechnik und strenger Indikationsstellung zur Bluttransfusion unter Ausnuetzung der Komponententherapie sinnvoll und sollte den personellen , apparativen und raeumlichen Moeglichkeiten des jeweiligen Krankenhauses angepasst werden . Die normovolaemische Haemodilution bildet dabei Grundlage und Ausgangspunkt aller Blutsparkonzepte . Die einzelnen Methoden ( normovolaemische Haemodilution , praeoperative Eigenblutspende und Plasmapherese , intra- und postoperative Autotransfusion mit oder ohne maschinelle Aufbereitung ) stehen in keinem Konkurrenzverhaeltnis zueinander , sondern erst die Kombination mehrerer Verfahren bringt einen optimalen Blutspareffekt . Zusaetzlich kann die Anwendung von Erythropoietin mit begleitender Eisentherapie und die Verbesserung der Haemostase mit Aprotinin zu einer weiteren Reduktion des Fremdblutverbrauchs fuehren . Praeoperativ gespendetes Eigenblut sollte genauso wie homologes Blut aufgetrennt werden . Ueber das Ausmass der notwendigen Testung sowie die Durchfuehrung von Eigenblutspenden bei Patienten mit Infektionen wie z.B. Hepatitis oder HIV herrscht derzeit noch keine allgemeine Uebereinstimmung . Die Durchfuehrung von Blutsparkonzepten erfordert Engagement und erhoehten Arbeitsaufwand der behandelnden Aerzte . Methoden zur Einsparung von Fremdblut sind jedoch notwendig um die Risiken der Transfusion von homologen Blutprodukten fuer die Patienten so gering wie moeglich zu halten .
DerAnaesthesist.50440191.ger.abstr-s1-r1-t1.2-t3.2
issue_in
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s6-t3
DerAnaesthesist.50440191.ger.abstr-s1-r2-t2.2-t3.2
surrounds
DerAnaesthesist.50440191.ger.abstr-s11-t2
DerAnaesthesist.50440191.ger.abstr-s6-t3
DerAnaesthesist.50440191.ger.abstr-s1-r3-t2.2-t1.2
surrounds
DerAnaesthesist.50440191.ger.abstr-s11-t2
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s1-r4-t1.1-t3.2
surrounds
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s6-t3
DerAnaesthesist.50440191.ger.abstr-s1-r6-t2.2-t3.2
issue_in
DerAnaesthesist.50440191.ger.abstr-s11-t2
DerAnaesthesist.50440191.ger.abstr-s6-t3
DerAnaesthesist.50440191.ger.abstr-s1-r7-t1.1-t3.2
issue_in
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s6-t3
DerAnaesthesist.50440191.ger.abstr-s2-r1-t3.2-t3.1
derivative_of
DerAnaesthesist.50440191.ger.abstr-s6-t3
DerAnaesthesist.50440191.ger.abstr-s11-t3
DerAnaesthesist.50440191.ger.abstr-s2-r2-t1.1-t2.1
conceptual_part_of
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s11-t2
DerAnaesthesist.50440191.ger.abstr-s2-r3-t3.1-t3.2
surrounds
DerAnaesthesist.50440191.ger.abstr-s11-t3
DerAnaesthesist.50440191.ger.abstr-s6-t3
DerAnaesthesist.50440191.ger.abstr-s2-r4-t3.1-t2.1
location_of
DerAnaesthesist.50440191.ger.abstr-s11-t3
DerAnaesthesist.50440191.ger.abstr-s11-t2
DerAnaesthesist.50440191.ger.abstr-s4-r2-t3.1-t1.2
method_of
DerAnaesthesist.50440191.ger.abstr-s11-t3
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s4-r3-t1.1-t3.1
location_of
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s11-t3
DerAnaesthesist.50440191.ger.abstr-s4-r5-t4.1-t1.2
method_of
DerAnaesthesist.50440191.ger.abstr-s11-t4
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s4-r7-t3.1-t4.2
uses
DerAnaesthesist.50440191.ger.abstr-s11-t3
DerAnaesthesist.50440191.ger.abstr-s11-t4
DerAnaesthesist.50440191.ger.abstr-s4-r10-t1.1-t4.1
location_of
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s11-t4
DerAnaesthesist.50440191.ger.abstr-s4-r11-t4.2-t3.1
carries_out
DerAnaesthesist.50440191.ger.abstr-s11-t4
DerAnaesthesist.50440191.ger.abstr-s11-t3
DerAnaesthesist.50440191.ger.abstr-s4-r12-t4.2-t1.2
issue_in
DerAnaesthesist.50440191.ger.abstr-s11-t4
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s6-r1-t3.2-t3.1
derivative_of
DerAnaesthesist.50440191.ger.abstr-s6-t3
DerAnaesthesist.50440191.ger.abstr-s11-t3
DerAnaesthesist.50440191.ger.abstr-s6-r2-t3.1-t5.1
location_of
DerAnaesthesist.50440191.ger.abstr-s11-t3
DerAnaesthesist.50440191.ger.abstr-s11-t5
DerAnaesthesist.50440191.ger.abstr-s6-r3-t3.1-t1.2
location_of
DerAnaesthesist.50440191.ger.abstr-s11-t3
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s6-r4-t3.1-t3.2
location_of
DerAnaesthesist.50440191.ger.abstr-s11-t3
DerAnaesthesist.50440191.ger.abstr-s6-t3
DerAnaesthesist.50440191.ger.abstr-s6-r5-t3.1-t3.2
surrounds
DerAnaesthesist.50440191.ger.abstr-s11-t3
DerAnaesthesist.50440191.ger.abstr-s6-t3
DerAnaesthesist.50440191.ger.abstr-s7-r1-t5.1-t4.1
produces
DerAnaesthesist.50440191.ger.abstr-s11-t5
DerAnaesthesist.50440191.ger.abstr-s11-t4
DerAnaesthesist.50440191.ger.abstr-s7-r2-t4.1-t1.1
interacts_with
DerAnaesthesist.50440191.ger.abstr-s11-t4
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s7-r3-t2.2-t1.1
produces
DerAnaesthesist.50440191.ger.abstr-s11-t2
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s7-r4-t4.1-t5.1
disrupts
DerAnaesthesist.50440191.ger.abstr-s11-t4
DerAnaesthesist.50440191.ger.abstr-s11-t5
DerAnaesthesist.50440191.ger.abstr-s7-r5-t2.1-t4.1
uses
DerAnaesthesist.50440191.ger.abstr-s11-t2
DerAnaesthesist.50440191.ger.abstr-s11-t4
DerAnaesthesist.50440191.ger.abstr-s7-r6-t1.1-t2.2
affects
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s11-t2
DerAnaesthesist.50440191.ger.abstr-s7-r7-t2.2-t5.2
produces
DerAnaesthesist.50440191.ger.abstr-s11-t2
DerAnaesthesist.50440191.ger.abstr-s7-t5
DerAnaesthesist.50440191.ger.abstr-s7-r8-t5.1-t2.1
location_of
DerAnaesthesist.50440191.ger.abstr-s11-t5
DerAnaesthesist.50440191.ger.abstr-s11-t2
DerAnaesthesist.50440191.ger.abstr-s7-r9-t5.2-t4.1
consists_of
DerAnaesthesist.50440191.ger.abstr-s7-t5
DerAnaesthesist.50440191.ger.abstr-s11-t4
DerAnaesthesist.50440191.ger.abstr-s7-r11-t1.1-t5.1
disrupts
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s11-t5
DerAnaesthesist.50440191.ger.abstr-s7-r12-t2.2-t4.1
produces
DerAnaesthesist.50440191.ger.abstr-s11-t2
DerAnaesthesist.50440191.ger.abstr-s11-t4
DerAnaesthesist.50440191.ger.abstr-s7-r13-t5.1-t5.2
surrounds
DerAnaesthesist.50440191.ger.abstr-s11-t5
DerAnaesthesist.50440191.ger.abstr-s7-t5
DerAnaesthesist.50440191.ger.abstr-s7-r14-t1.1-t4.1
interacts_with
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s11-t4
DerAnaesthesist.50440191.ger.abstr-s7-r15-t5.2-t5.1
derivative_of
DerAnaesthesist.50440191.ger.abstr-s7-t5
DerAnaesthesist.50440191.ger.abstr-s11-t5
DerAnaesthesist.50440191.ger.abstr-s7-r16-t5.1-t2.2
location_of
DerAnaesthesist.50440191.ger.abstr-s11-t5
DerAnaesthesist.50440191.ger.abstr-s11-t2
DerAnaesthesist.50440191.ger.abstr-s7-r17-t5.1-t1.1
produces
DerAnaesthesist.50440191.ger.abstr-s11-t5
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s7-r18-t4.1-t2.2
affects
DerAnaesthesist.50440191.ger.abstr-s11-t4
DerAnaesthesist.50440191.ger.abstr-s11-t2
DerAnaesthesist.50440191.ger.abstr-s8-r1-t2.2-t1.1
derivative_of
DerAnaesthesist.50440191.ger.abstr-s11-t2
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s8-r4-t2.2-t1.2
derivative_of
DerAnaesthesist.50440191.ger.abstr-s11-t2
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s8-r5-t1.1-t2.2
surrounds
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s11-t2
DerAnaesthesist.50440191.ger.abstr-s8-r6-t1.2-t2.2
surrounds
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s11-t2
DerAnaesthesist.50440191.ger.abstr-s9-r1-t5.1-t3.1
causes
DerAnaesthesist.50440191.ger.abstr-s11-t5
DerAnaesthesist.50440191.ger.abstr-s11-t3
DerAnaesthesist.50440191.ger.abstr-s9-r2-t3.1-t1.2
occurs_in
DerAnaesthesist.50440191.ger.abstr-s11-t3
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s9-r3-t1.1-t3.1
location_of
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s11-t3
DerAnaesthesist.50440191.ger.abstr-s9-r5-t5.1-t4.1
causes
DerAnaesthesist.50440191.ger.abstr-s11-t5
DerAnaesthesist.50440191.ger.abstr-s11-t4
DerAnaesthesist.50440191.ger.abstr-s9-r6-t4.1-t1.2
occurs_in
DerAnaesthesist.50440191.ger.abstr-s11-t4
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s9-r7-t3.1-t1.1
produces
DerAnaesthesist.50440191.ger.abstr-s11-t3
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s9-r8-t1.1-t5.1
location_of
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s11-t5
DerAnaesthesist.50440191.ger.abstr-s9-r10-t3.1-t5.1
affects
DerAnaesthesist.50440191.ger.abstr-s11-t3
DerAnaesthesist.50440191.ger.abstr-s11-t5
DerAnaesthesist.50440191.ger.abstr-s9-r11-t1.2-t3.1
causes
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s11-t3
DerAnaesthesist.50440191.ger.abstr-s9-r12-t4.1-t1.1
produces
DerAnaesthesist.50440191.ger.abstr-s11-t4
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s9-r13-t3.1-t1.2
produces
DerAnaesthesist.50440191.ger.abstr-s11-t3
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s9-r14-t4.1-t5.1
affects
DerAnaesthesist.50440191.ger.abstr-s11-t4
DerAnaesthesist.50440191.ger.abstr-s11-t5
DerAnaesthesist.50440191.ger.abstr-s9-r15-t1.1-t4.1
location_of
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s11-t4
DerAnaesthesist.50440191.ger.abstr-s9-r16-t1.2-t4.1
causes
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s11-t4
DerAnaesthesist.50440191.ger.abstr-s9-r17-t4.1-t1.2
produces
DerAnaesthesist.50440191.ger.abstr-s11-t4
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s11-r1-t4.2-t1.1
uses
DerAnaesthesist.50440191.ger.abstr-s11-t4
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s11-r3-t4.1-t2.2
surrounds
DerAnaesthesist.50440191.ger.abstr-s11-t4
DerAnaesthesist.50440191.ger.abstr-s11-t2
DerAnaesthesist.50440191.ger.abstr-s11-r4-t4.2-t1.2
uses
DerAnaesthesist.50440191.ger.abstr-s11-t4
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s11-r5-t1.2-t4.2
surrounds
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s11-t4
DerAnaesthesist.50440191.ger.abstr-s11-r6-t1.2-t2.2
surrounds
DerAnaesthesist.50440191.ger.abstr-s11-t1
DerAnaesthesist.50440191.ger.abstr-s11-t2