El documento discute la necesidad de adoptar un nuevo paradigma para evitar las transfusiones en procedimientos estéticos. Señala que las transfusiones aumentan el riesgo de complicaciones como infección, falla multiorgánica y mortalidad. Propone estrategias como optimizar la hemostasia, medir y controlar agresivamente el sangrado, y usar criterios restrictivos para transfundir solo cuando la hemoglobina es menor a 7 g/dL. El objetivo es realizar procedimientos estéticos de manera más segura reduciendo los riesgos asociados con las trans

1. Transfusiones en Estética y la Necesidad de un Nuevo Paradigma Miguel Florez Rueda Marzo 2011 Medellín

3. Comité de Seguridad en Cirugía Plástica

4. ¿Es Posible Evitar las Transfusiones en los Procedimientos Estéticos?

6. «Un Estado de Completo Bienestar Físico, Mental Y Social, y No Solamente la Ausencia de Afecciones o Enfermedades»

7. SON PERSONAS QUE SE SOMETEN A PROCEDIMIENTOS ELECTIVOS, NO SON PACIENTES SANOS.

13. Anesthesiology 2011; 114: 283–92 Results: Intraoperative blood transfusion was associated with an increased risk of death (odds ratio [OR], 1.29; 95%CI, 1.03–1.62). Patients receiving an intraoperative transfusion were more likely to have pulmonary, septic, wound, or thromboembolic complications , compared with patients not receiving an intraoperative transfusion. Compared with patients who were not transfused, patients receiving one or two units of erythrocytes were more likely to have pulmonary complications (OR, 1.76; 95% CI, 1.48 –2.09), sepsis (OR, 1.43; 95% CI, 1.21–1.68), thromboembolic complications (OR, 1.77; 95% CI, 1.32–2.38), and wound complications (OR, 1.87; 95% CI, 1.47–2.37).

17. RESTAURAR VOLUMEN INTRAVASCULAR.

23. Relación entre Gasto Cardiaco y Valor de Hemoglobina

27. The silent risks of blood transfusion James Rawn Current Opinion in Anaesthesiology 2008, 21:664–668 Summary The benefits of blood transfusion have never been conclusively demonstrated, but evidence of transfusion-related harm continues to accumulate. Given the transfusion triggers that currently predominate in clinical practice it appears that clinical outcomes could improve significantly with more widespread adoption of restrictive transfusion strategies.

28. QUE SON LAS ESTRATEGIAS PARA EVITAR LAS TRANSFUSIONES?

30. PORQUE SON NECESARIAS LAS ESTRATEGIAS PARA EVITAR LAS TRANSFUSIONES?

32. PARA DISMINUIR RIESGOS Y BRINDAR SEGURIDAD PARA EL PACIENTE

43. DISMINUIR COSTOS

45. EXISTEN PACIENTES QUE NO ACEPTAN SER TRANSFUNDIDOS

47. DISPONIBILIDAD DE SANGRE

49. Ozier et al.: HEMOSTATIC DRUGS AND PERIOPERATIVE BLOOD LOSS CAN J ANESTH 2006 / 53: 6 / pp S21–S29

50. EVITAR LA MORTALIDAD Y DISMINUIR LAS ESTANCIAS.

62. OPTIMIZAR LA HEMOSTASIA:

65. DETECCIÓN DE LA ANEMIA PREOPERATORIA.

67. Results: Preoperative anemia was common and equal between genders (39.5% for men and 39.9% for women) and was associated with a nearly five-fold increase in the odds of postoperative mortality . After adjustment for major confounders using logistic regression, anemia was still associated with increased mortality (odds ratio, 2.36; 95% confidence interval, 1.57–3.41). This relationship was unchanged after elimination of patients with severe anemia and patients who received transfusions. In a propensity-matched cohort of patients, anemia was associated with increased mortality (odds ratio, 2.29; 95% confidence interval, 1.45–3.63).

68. Beattie W.S, Karkouti. K , Wijeysundera. D.N, Tait. G. Risk Associated with Preoperative Anemia in Noncardiac Surgery. Anesthesiology 2009; 110:574–81

70. GOODNOUGH, L.T. Evaluation of anemia in the elective surgical patient Transfusion. Alternatives in Transfusion Medicine 9 (Suppl. 2), 10–12

71. CALCULAR LAS POSIBLES PÉRDIDAS SANGUÍNEAS

76. OPTIMIZACIÓN DE LA MASA GLÓBULOS ROJOS

90. ACCION INTERVECIONISTA, TRATAMENTO

92. TÉCNICAS ANESTÉSICAS DIRIGIDAS A DISMINUIR LA POSIBILIDAD DE SANGRADO.

95. TÉCNICAS DE TRANSFUSIÓN AUTO LOGA.

97. DONACIÓN PREOPERATORIA. (PAD)

102. G. Rock et al. G. Rock et al. An autologous blood programme Transfusion Medicine, 2006: 16, 307–311

105. HEMODILUCION NORMOVOLEMICA AGUDA (ANH)

110. RESCATE PERI OPERATORIO DE GLÓBULOS ROJOS.

115. USO DE AGENTES HEMOSTÁTICOS SISTÉMICOS.

117. TÉCNICAS QUIRÚRGICAS

120. GOODNOUG, L.T. Evaluation of anemia in the elective surgical patient Transfusion. Alternatives in Transfusion Medicine 9 (Suppl. 2), 10–12

122. Madjdpour and Spahn Allogeneic red blood cell transfusions: efficacy, risks, alternatives and indications Br J Anaesth 2005; 95: 33–42

125. ? SI.

126. GRACIAS