Zusammenfassung
Die Transfusion von allogenen Blutprodukten ist mit einer Erhöhung der perioperativen
Morbidität und Letalität assoziiert. Störungen der Hämostase sind insbesondere bei
kardiochirurgischen Patienten häufig anzutreffen und können zu transfusionspflichtigen
Blutungen führen. Eine zielgerichtete Therapie der häufig komplexen Gerinnungsstörungen
erfordert eine differenzierte Diagnostik.
Abstract
The transfusion of allogeneic blood products is associated with increased morbidity
and mortality. An impaired hemostasis is frequently found in patients undergoing cardiac
surgery and may in turn cause bleeding and transfusions. A goal directed coagulation
management addressing the often complex coagulation disorders needs sophisticated
diagnostics. This may improve both patientsʼ outcome and costs. Recent data suggest
that coagulation management based on a rational algorithm is more effective than traditional
therapy based on conventional laboratory variables such as PT and INR. Platelet inhibitors,
cumarins, direct oral anticoagulants and heparin need different diagnostic and therapeutic
approaches. An algorithm specifically developed for use during cardiac surgery is
presented.
Schlüsselwörter
Gerinnung - Herzchirurgie - Algorithmus - Kardioanästhesie - Antikoagulanzien
Key words
Coagulation - cardiac surgery - algorithm - cardiac anaesthesia - anticoagulants
