Emergency general surgeons often provide care to severely ill patients requiring surgical interventions and intensive support. One of the primary drivers of morbidity and mortality is perioperative bleeding. In general, when addressing life threatening haemorrhage, blood transfusion can become an essential part of overall resuscitation. However, under all circumstances, indications for blood transfusion must be accurately evaluated. When patients decline blood transfusions, regardless of the reason, surgeons should aim to provide optimal care and respect and accommodate each patient’s values and target the best outcome possible given the patient’s desires and his/her clinical condition. The aim of this position paper was to perform a review of the existing literature and to provide comprehensive recommendations on organizational, surgical, anaesthetic, and haemostatic strategies that can be used to provide optimal peri-operative blood management, reduce, or avoid blood transfusions and ultimately improve patient outcomes.

中文翻译：

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紧急普外科中预防失血和减少输血的策略，WSES-AAST 共识文件


急诊普通外科医生经常为需要手术干预和强化支持的重症患者提供护理。发病率和死亡率的主要驱动因素之一是围手术期出血。一般来说，在解决危及生命的出血时，输血可能成为整体复苏的重要组成部分。然而，在任何情况下，都必须准确评估输血的指征。当患者拒绝输血时，无论出于何种原因，外科医生都应致力于提供最佳护理并尊重和适应每位患者的价值观，并根据患者的愿望和临床状况争取最佳结果。本立场文件的目的是对现有文献进行回顾，并提供有关组织、手术、麻醉和止血策略的全面建议，这些策略可用于提供最佳的围手术期血液管理、减少或避免输血和止血。最终改善患者的治疗效果。