Hemotherapy in surgery
1. Big picture
Hemotherapy in surgery means the rational use of blood and blood components before, during, and after surgery to correct anemia, bleeding, coagulopathy, thrombocytopenia, and massive hemorrhage.
The examiner wants you to think in two directions:
Is the patient losing oxygen-carrying capacity?
→ give red blood cells if needed
Is the patient unable to clot?
→ give the missing component: platelets, plasma, fibrinogen/cryoprecipitate, PCC
The key surgical principle is:
Transfusion is supportive therapy; it does not replace surgical hemostasis. If the patient is bleeding, the surgeon must find and control the source.
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