Intraoperative Bleeding Management: An Updating Literature Review: Review Article

Background: Intraoperative bleeding remains a major complication during and after surgery, leading to increased morbidity and mortality. Several influences determine the complex causes of bleeding in surgical patients. About 75 to 90% of early intraoperative and postoperative bleeding is due to technical factors. In some cases, however, acquired or congenital coagulopathies can stimulate, if not directly cause, surgical bleeding.

Objectives: This paper aims to overview etiology, causes, diagnosis, and updated management of intraoperative bleeding.

Methods: The review article ran from July 1, 2021 to October 31, 2021. We searched articles on etiology, causes, and treatments published in English worldwide in the Medline, EBSCO and PubMed databases. No software was used to analyze the data. Team members reviewed the data to determine initial results.

Results: All patients scheduled for elective surgery should be screened for possible hemostatic defects using tests, and, if necessary, laboratory tests. Treatment of intraoperative bleeding consists of identifying patients at risk and understanding the effect of surgery on hemostasis. For patients at high risk of bleeding, a pre-operative meeting with a multidisciplinary team (anesthesiologist, surgeon, hematologist, radiologist) can discuss the correct surgical procedure.

Conclusion: Technical variables account for 75-90% of initial intraoperative and postoperative bleeding. However, in other cases it is associated with acquired or congenital coagulation disorders. All patients scheduled for elective surgery should be checked for problems with hemostasis. Treatment of intraoperative bleeding involves identifying those at risk and understanding the effect of surgery on hemostasis.