Trombocitopenia hereditaria: manejo perioperatorio en pacientes en cirugía cardíaca

Abstract

Hereditary thrombocytopenia (HT) presents a significant challenge in the perioperative management of patients undergoing cardiac surgery due to the increased risk of hemorrhagic complications. This paper aims to analyze current strategies for the perioperative management of HT in cardiac surgery patients. A comprehensive literature review was conducted across various databases, and 43 high-quality studies were selected. The results highlight the importance of a thorough preoperative evaluation, including a detailed clinical history, physical examination, specific platelet function tests, and close follow-up with hematology. Therefore, it is important to emphasize that optimal perioperative management requires a multidisciplinary approach, with individualized strategies for each patient. Key measures primarily include optimizing the platelet count through transfusional support, the use of hemostatic agents, and drugs that improve platelet function, along with meticulous surgical techniques. Furthermore, close monitoring of hemostasis is essential throughout the procedure and in the immediate postoperative period. In conclusion, the perioperative management of HT in cardiac surgery demands a comprehensive and coordinated approach tailored to individual needs. Only through methodical planning, multidisciplinary teamwork, and continuous vigilance can outcomes be optimized and the risks associated with this complex hematological condition be minimized.