Nursing care of patients with "zero blood transfusion" type A aortic dissection in perioperative period / 中国实用护理杂志

ABSTRACT

Objective:To summarize the nursing experience of 7 cases of "zero blood transfusion" type A acute aortic dissection during the perioperative period.Methods:Preoperative risk assessment, control of heart rate, blood pressure, analgesia and sedation to avoid dissection;fully keep warm during operation and recover blood from operation field;after operation, avoid heart rate and blood pressure fluctuations to reduce oozing, monitor coagulation indicators, observe the amount and characteristics of drainage fluid, ensure the safety of anticoagulation during Renal replacement therapy, and avoid blood waste.Results:The 7 patients all transitioned to the operation smoothly. Intraoperative and postoperative infusion of pre-storage and recovery autologous blood of 200-1 200 ml, no allogeneic blood transfusion. One patient had a lot of drainage after surgery. The drainage volume was 1 450 ml on the day and the first day. He was given autologous blood infusion combined with hemostatic drugs, and the hemoglobin could be maintained above 80 g/L; 2 patients complicated with hypoxemia, were sequential High-flow oxygen; 2 patients with acute kidney injury underwent continuous renal replacement therapy without unplanned dismissal. All 7 patients recovered and were discharged after active treatment.Conclusions:For patients with type A acute aortic dissection surgery, through careful blood protection care, you can reduce dependence on allogeneic blood.