Abstract

DELGADO, Fernando; MACHADO, Washington  and  MACHADO, Gonzalo. Management of bleeding in the cardiac surgery setting. Rev.Urug.Cardiol. [online]. 2020, vol.35, n.3, pp.234-274.  Epub Dec 01, 2020. ISSN 0797-0048.  https://doi.org/10.29277/cardio.35.3.16.

Any surgical procedure is detrimental to the body. Cardiac surgery with the necessary use of cardiopulmonary bypass particularly impacts on multiple systems. In this review, emphasis will be placed on its impact on hemostasis.

Bleeding is one of the most frequent complications and with the highest morbidity and mortality in these patients. Although it is caused by a number of factors, the surgical technique, the cardiopulmonary bypass time and the pre-existing diseases acquire special relevance.

The appearance of new procoagulant drugs and systems for monitoring hemostasis, the use of management protocols, with good evidence but low adherence, have so far not been able to reduce the use of blood components.

In this review we analyse the current recommendations for the management of bleeding in cardiac surgery, its prevention through the preoperative optimization of the patient, stratify their risk, maintain intraoperative hemostasis and treat postoperative bleeding complications in those patients who suffer them.

Keywords : Postoperative bleeding; Prophylaxis; Management.

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