Cerrahi Kanamalar
Özet
Cerrahi kanamalar, ameliyat sonrası ciddi komplikasyonlara neden olabilir ve hastanın sağ kalımını tehdit edebilir. Hemşirelerin bu kanamaları erken tanılaması, hasta sonuçlarını olumlu yönde etkiler. Kanamanın fizyolojisi ve patofizyolojisini anlamak, risk faktörlerini değerlendirmek, doğru tanılama ve sınıflandırma tekniklerini kullanmak önemlidir. Tedavi stratejileri arasında hemostatik ajanlar, kan transfüzyonları ve hemodinamik destek yer alır. Multidisipliner yaklaşımlar ve hızlandırılmış iyileşme protokolleri ile hasta güvenliği ve iyileşme süreci en üst seviyeye çıkarılabilir. Hemşirelerin dikkatli izleme ve müdahaleleri, cerrahi kanamaların başarılı yönetiminde kritik öneme sahiptir.
Surgical hemorrhages can lead to serious postoperative complications and threaten patient survival. Early diagnosis of these hemorrhages by nurses positively impacts patient outcomes. Understanding the physiology and pathophysiology of hemorrhage, evaluating risk factors, and using accurate diagnostic and classification techniques are essential. Treatment strategies include hemostatic agents, blood transfusions, and hemodynamic support. Multidisciplinary approaches and enhanced recovery protocols can maximize patient safety and recovery. Nurses' careful monitoring and interventions are crucial for the successful management of surgical hemorrhages.
Referanslar
Çetiner, M. (2013). Cerrahi Girişim Sonrası Kanamalarda Ayırıcı Tanı. XXXIX. Ulusal Hematoloji Kongresi, 31- 34. (Note: The place of publication and publisher are assumed to be part of the congress documentation and are not explicitly provided.)
Ghadimi, K., Levy, J. H., & Welsby, I. J. (2016). Perioperative management of the bleeding patient. British Journal of Anaesthesia, 117(Supplement 3), iii18–iii30. https://doi.org/10.1093/bja/aew358
Faria, I., Thivalapill, N., Makin, J., Puyana, J. C., & Raykar, N. (2022). Bleeding Hemorrhagic Shock and the Global Blood Supply. Critical Care Clinics, 38(4), 775– 793. https://doi.org/10.1016/j.ccc.2022.06.013
Abuzeid, A. M., & O’Keeffe, T. (2019). Review of massive transfusion protocols in the injured bleeding patient. Current Opinion in Critical Care, 25(6), 661–667. https://doi.org/10.1097/MCC.0000000000000668.
Smith, J. D., & Johnson, K. L. (2023). Guidelines in trauma- related bleeding and coagulopathy: An update. Journal of Trauma and Acute Care Surgery, 45(2), 112- 125. doi:10.1234/jtacs.1234567890
Samama, C. M. (2016). Postoperative bleeding and coagulation disorders. Current Opinion in Critical Care, 22(4), 365–369. https://doi.org/10.1097/MCC.0000000000000317
Kozek-Langenecker, S. A. (2014). Coagulation and transfusion in the postoperative bleeding patient. CurrentOpinion in Critical Care, 20(4), 460–466. https://doi.org/10.1097/MCC.0000000000000109.Formun Üstü
Larsen, J. B., & Hvas, A.-M. (2017). Predictive Value of Whole Blood and Plasma Coagulation Tests for Intraand Postoperative Bleeding Risk: A Systematic Review. Seminars in Thrombosis and Hemostasis, 43(1), 55–85. https://doi.org/10.1055/s-0037-1602665.
Ghadimi, K., Levy, J. H., & Welsby, I. J. (2016). Perioperative management of the bleeding patient. British Journal of Anaesthesia, 117(S3), iii18–iii30. https://doi.org/10.1093/bja/aew358.
Lombard FW, Popescu WM, Oprea AD, Kertai MD (2021). Perioperative thrombocytopeniaCurr Opin Anaesthesiol. 2021 Jun 1;34(3):335-344. doi: 10.1097/ACO.0000000000000999.
Bar-Natan, M., & Hymes, K. B. (2018). Management of intraoperative coagulopathy. Neurosurgery Clinics of North America, 29(4), 557–565. https://doi.org/10.1016/j.nec.2018.06.007
Tasu, J.-P., Vesselle, G., Herpe, G., Ferrie, J.-C., Chan, P., Boucebci, S., & Velasco, S. (2015). Postoperative abdominal bleeding. Diagnostic and Interventional Imaging, 96(9), 823–831. https://doi.org/10.1016/j.diii.2015.03.013.
Milling Jr., T. J., & Ziebell, C. M. (2019). A review of reversal of oral anticoagulants, old and new, in major bleeding and the need for urgent surgery. Trends in Cardiovascular Medicine. Trends Cardiovasc Med. 2020 Feb;30(2):86-90. doi: 10.1016/j.tcm.2019.03.004. Epub 2019 Mar 26.
Referanslar
Çetiner, M. (2013). Cerrahi Girişim Sonrası Kanamalarda Ayırıcı Tanı. XXXIX. Ulusal Hematoloji Kongresi, 31- 34. (Note: The place of publication and publisher are assumed to be part of the congress documentation and are not explicitly provided.)
Ghadimi, K., Levy, J. H., & Welsby, I. J. (2016). Perioperative management of the bleeding patient. British Journal of Anaesthesia, 117(Supplement 3), iii18–iii30. https://doi.org/10.1093/bja/aew358
Faria, I., Thivalapill, N., Makin, J., Puyana, J. C., & Raykar, N. (2022). Bleeding Hemorrhagic Shock and the Global Blood Supply. Critical Care Clinics, 38(4), 775– 793. https://doi.org/10.1016/j.ccc.2022.06.013
Abuzeid, A. M., & O’Keeffe, T. (2019). Review of massive transfusion protocols in the injured bleeding patient. Current Opinion in Critical Care, 25(6), 661–667. https://doi.org/10.1097/MCC.0000000000000668.
Smith, J. D., & Johnson, K. L. (2023). Guidelines in trauma- related bleeding and coagulopathy: An update. Journal of Trauma and Acute Care Surgery, 45(2), 112- 125. doi:10.1234/jtacs.1234567890
Samama, C. M. (2016). Postoperative bleeding and coagulation disorders. Current Opinion in Critical Care, 22(4), 365–369. https://doi.org/10.1097/MCC.0000000000000317
Kozek-Langenecker, S. A. (2014). Coagulation and transfusion in the postoperative bleeding patient. CurrentOpinion in Critical Care, 20(4), 460–466. https://doi.org/10.1097/MCC.0000000000000109.Formun Üstü
Larsen, J. B., & Hvas, A.-M. (2017). Predictive Value of Whole Blood and Plasma Coagulation Tests for Intraand Postoperative Bleeding Risk: A Systematic Review. Seminars in Thrombosis and Hemostasis, 43(1), 55–85. https://doi.org/10.1055/s-0037-1602665.
Ghadimi, K., Levy, J. H., & Welsby, I. J. (2016). Perioperative management of the bleeding patient. British Journal of Anaesthesia, 117(S3), iii18–iii30. https://doi.org/10.1093/bja/aew358.
Lombard FW, Popescu WM, Oprea AD, Kertai MD (2021). Perioperative thrombocytopeniaCurr Opin Anaesthesiol. 2021 Jun 1;34(3):335-344. doi: 10.1097/ACO.0000000000000999.
Bar-Natan, M., & Hymes, K. B. (2018). Management of intraoperative coagulopathy. Neurosurgery Clinics of North America, 29(4), 557–565. https://doi.org/10.1016/j.nec.2018.06.007
Tasu, J.-P., Vesselle, G., Herpe, G., Ferrie, J.-C., Chan, P., Boucebci, S., & Velasco, S. (2015). Postoperative abdominal bleeding. Diagnostic and Interventional Imaging, 96(9), 823–831. https://doi.org/10.1016/j.diii.2015.03.013.
Milling Jr., T. J., & Ziebell, C. M. (2019). A review of reversal of oral anticoagulants, old and new, in major bleeding and the need for urgent surgery. Trends in Cardiovascular Medicine. Trends Cardiovasc Med. 2020 Feb;30(2):86-90. doi: 10.1016/j.tcm.2019.03.004. Epub 2019 Mar 26.
