Interventional Algorithms for the Control of Coagulopathic Bleeding in Surgical, Trauma, and Postpartum Settings – Recommendations From the Share Network Group
Manuela Carvalho, MD 1); Anabela Rodrigues, MD 2); Manuela Gomes, MD 3); Alexandre Carrilho, MD 4); António Robalo Nunes, MD 5); Rosário Orfão, MD 6); Ângela Alves, MD 7); José Aguiar, MD 8); and Manuel Campos, MD 9)
1 – Transfusion Medicine and Blood Bank Department, H. São João, Centro Hospitalar São João, Porto, Portugal
2 – Transfusion Medicine Department, H. Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
3 – Transfusion Medicine Department, H. Santa Cruz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal
4 – Anesthesiology Department, H. São José, Centro Hospitalar Lisboa Central, Lisboa, Portugal
5 – Transfusion Medicine Department, H. Pulido Valente, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
6 – Anesthesiology Department, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
7 – Anesthesiology Department, H. Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
8 – Anesthesiology Department, H. Santo António, Centro Hospitalar do Porto, Porto, Portugal
9 – Clinical Hematology Department, H. Santo António, Centro Hospitalar do Porto, Porto, Portugal
Abstract
Several clinical settings are associated with specific coagulopathies that predispose to uncontrolled bleeding. With the growing concern about the need for optimizing transfusion practices and improving treatment of the bleeding patient, a group of 9 Portuguese specialists (Share Network Group) was created to discuss and develop algorithms for the clinical evaluation and control of coagulopathic bleeding in the following perioperative clinical settings: surgery, trauma, and postpartum hemorrhage. The 3 algorithms developed by the group were presented at the VIII National Congress of the Associac¸a˜o Portuguesa de Imunohemoterapia in October 2013. They aim to provide a structured approach for clinicians to rapidly diagnose the status of coagulopathy in order to achieve an earlier and more effective bleeding control, reduce transfusion requirements, and improve patient outcomes. The group highlights the importance of communication between different specialties involved in the care of bleeding patients in order to achieve better results.