Perioperative Care; Fluid and Electrolyte

Haemorrhage

Haemorrhage can be classified as:

• ‘Primary’: occurring when a vessel is cut during surgery.
• ‘Reactionary’: occurring when rises in blood pressure at the end of the operation cause vessels that had previously not been bleeding to start to do so.
• ‘Secondary’: normally due to infection which causes damage to a vessel days after surgery.

The increased risk of haemorrhage may be multi-factorial in origin the management of haemorrhage depends on the cause but may include fluid and blood product resuscitation, reversal of anti-coagulant effect and surgical intervention. Some drugs and techniques may play a part in reducing blood loss and the need for blood transfusion. Risk factor Cause Drugs Heparin, warfarin, non-steroidal anti-inflammatory agents, anti-platele drugs Congenital bleeding disorder Haemophilia, von Willebrand disease Acquired bleeding disorder Sepsis, liver disease, disseminated.