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Η διεγχειρητική αντιμετώπιση της απώλειας αίματος στα παιδιά PowerPoint PPT Presentation


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Η διεγχειρητική αντιμετώπιση της απώλειας αίματος στα παιδιά. Οικονομόπουλος Δαυίδ Αναισθησιολόγος.

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Η διεγχειρητική αντιμετώπιση της απώλειας αίματος στα παιδιά

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4239140


4239140

(HIV), (HBV), (HCV), (WNV) 10 ml


4239140

(EBV)

  • 100 120 ml/kg

  • 90 ml/kg

  • 80 mL/kg 3 12

  • 70 ml/kg

  • 65 ml/kg


The maximal allowable blood loss mabl

(the maximal allowable blood loss - MABL)


4239140

MABL R/L 1 3, 1 1, (PRBCs)


4239140

MABL , RBCs 20% 25%. 20%


4239140


15 20 35

15 , 20 35:


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(FFP)

  • ( )


4239140

  • FFP 1 1.5

  • , FFP


4239140

  • FFP PT PTT

  • PT PTT , FFP


4239140

  • oozing

  • PT 15

  • PTT 60 (>1.5 )


4239140

FFP

  • oozing

  • (.. ),


4239140

  • FFP 30%

  • FFP 1.0 mL/kg/min


4239140

(PLT)

( ) 50000/mm3


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  • ( 100.000/mm3)

  • (150.000 350.000/mm3)


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  • 0.1 0.3 U/kg (5 ml/kg)


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  • SpHb

  • SpHct

  • Vigileo

  • ( , , )


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  • 40%


4239140

  • (CMV).

  • , ()

  • (, )


4239140

-

  • 4-6

  • 5-10


4239140


4239140

-

-

-


4239140

  • .


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Tzortzopoulou A, Cepeda MS, Schumann R, Carr DB.: Cochrane Database Syst Rev. 2008 Jul 16Antifibrinolytic agents for reducing blood loss in scoliosis surgery in children.Department of Anesthesia, Tufts Medical Center, Boston, MassachusettsCot CJ, Zaslavsky A, Downes JJ, et al: Postoperative apnea in former preterm infants after inguinal herniorrhaphy. A combined analysis. Anesthesiology 1995; 82:809-822.Barcelona SL, Thompson AA, Cot CJ: Intraoperative pediatric blood transfusion therapy: A review of common issues. Part I: Hematologic and physiologic differences from adults; metabolic and infectious risks. Paediatr Anaesth 2005; 15:716-726. Barcelona SL, Thompson AA, Cot CJ: Intraoperative pediatric blood transfusion therapy: A review of common issues. Part II: Transfusion therapy, special considerations, and reduction of allogenic blood transfusions. Paediatr Anaesth 2005; 15:814-830. Cot CJ: Blood, colloid, and crystalloid therapy. Anesthesiol Clin North Am 1991; 9:865-884. 120.. Barcelona SL, Cot CJ: Pediatric resuscitation in the operating room. Anesthesiol Clin North Am 2001; 19:339-365. Cot CJ, Drop LJ, Hoaglin DC, et al: Ionized hypocalcemia after fresh frozen plasma administration to thermally injured children: Effects of infusion rate, duration, and treatment with calcium chloride. Anesth Analg 1988; 67:152-160. Cot CJ: Depth of halothane anesthesia potentiates citrate-induced ionized hypocalcemia and adverse cardiovascular events in dogs. Anesthesiology 1987; 67:676-680. Cot CJ, Drop LJ, Daniels AL, Hoaglin DC: Calcium chloride versus calcium gluconate: Comparison of ionization and cardiovascular effects in children and dogs. Anesthesiology 1987; 66:465-470. Cot CJ, Liu LM, Szyfelbein SK, et al: Changes in serial platelet counts following massive blood transfusion in pediatric patients. Anesthesiology 1985; 62:197-201. Barcelona SL, Vilich F, Cot CJ: A comparison of flow rates and warming capabilities of the Level 1 and Rapid Infusion System with various-size intravenous catheters.Anesth Analg 2003; 97:358-363.


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