Management in health care
  • 2020 № 9 Organization, current state and immediate prospects of the problem «bloodless surgery»

    The research focus of the publication is the problem of preserving the blood of the operated patient. The variety
    of blood preservation methods shows the multidisciplinary nature of the problem and the importance of well-coordinated
    teamwork of busy doctors. For more than 20 years, surgical, anesthetic, transfusion technologies of blood saving have
    been used mainly in cardiac surgery patients. The use of a complex of blood-saving technologies allows you to reduce
    the amount of blood loss and the consumption of donor blood components. Over 7 years in cardiac surgery, the number
    of recipients of donor hemocomponents decreased by 41% (erythrovesue) and 61% (FFP). Autologous plasma is 68-78%
    of the total volume transfused to cardiac patients. 50% of patients operated on the ascending aorta do not need a blood
    transfusion. Blood loss during extensive liver resections has decreased three times in 10 years and does not require allogeneic blood transfusions. An adequate multidisciplinary approach to solving the problem of blood conservation can improve
    the results of surgical treatment of patients.

    Authors: Polyakova Yu. V. [3] Solovyova I. N. [2] Cherkasov G. E. [1] Trekova N. A [1]

    Tags: blood saving1 blood saving efficiency1 interdisciplinary problem1 surgical blood saving1 transfusion blood saving1

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  • 2020 № 2 Оrganization of extracorporeal care in a multidisciplinary medical institution

    Organization of round-the-clock extracorporeal (EC) treatment in required volumes and options is one of the
    most important tasks of a modern surgical hospital. The annual volume of extracorporeal procedures at the B. V. Petrovsky
    National Research Center for Surgery (NRCS) is 1.5–2.0 thousand. The most significant methods are transfusiological blood
    saving, high-volume plasmapheresis, and renal replacement therapy. Doctors of various specialties are traditionally engaged
    in conducting EC procedures: resuscitators, nephrologists, transfusiologists. In modern medicine, EC hemocorrection
    methods are in wide demand. Their effectiveness can be determined by the start time of the procedure. Therefore, roundthe-
    clock access to all the necessary manipulations is important. In the absence of specialized departments of extracorporeal
    treatment with around-the-clock working schedule the implementation of the necessary extracorporeal procedures is
    possible in close contact with resuscitators, nephrologists, transfusiologists, in collaboration with the doctor of the clinical
    diagnostic laboratory. The quality of providing high-tech extracorporeal care depends on the adequacy of the treatment
    process management in a particular medical institution. Collegial performance of EC procedures for one patient by specialists
    of various profiles – resuscitators, nephrologists, transfusiologists – gives a high clinical result.

    Authors: Polyakova Yu. V. [3] Solovyova I. N. [2] Marchenko T. V. [1]

    Tags: extracorporeal hemocorrection1 high volume plasma exchange1 nephrology1 renal replacement therapy2 resuscitation1 transfusiological blood saving1 transfusiology1

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