Perioperative management of patients with hemostatic system disorders. Methodological recommendations of the All-Russian public organization “Federation of Anesthesiologists and Reanimatologists” and the National Association of Specialists in Thrombosis, Clinical Hemostasiology and Hemorheology

Abstract

Perioperative coagulation disorders pose a serious risk of life-threatening complications. The article presents methodological recommendations of the Federation of Anesthesiologists and reanimatologists of Russian Federation for the perioperative management of patients with disorders of the hemostatic system, which summarizes aspects of both diagnosis and assessment, and intensive care of congenital and acquired disorders of the coagulation system in the perioperative period. The literature search focused on meta-analyses and randomized controlled trials, but also included registries, non-randomized comparative and descriptive studies, case series, cohort studies, systematic reviews, and expert opinion. The principles of perioperative management of disseminated intravascular coagulation syndrome, hepatic, uremic, traumatic, septic coagulopathy, acquired thrombocytopenia and trobocytopathies, antiphospholipid syndrome, hemophilia A and B, von Willebrand disease and other pathologies are described. For each recommendation, the level of certainty of the evidence and the level of strength of the evidence are presented. The recommendations were developed by experts in the field of perioperative patient management for anesthesiologists and intensive care physicians as a help in making clinical decisions; the final decision for a particular patient is made by the attending physician.