8 results on '"Neef, Vanessa"'
Search Results
2. Strategies to increase patient safety in obstetric anesthesia.
- Author
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Neef V
- Subjects
- Humans, Pregnancy, Female, Patient Safety standards, Anesthesia, Obstetrical adverse effects, Anesthesia, Obstetrical methods, Anesthesia, Obstetrical standards
- Published
- 2024
- Full Text
- View/download PDF
3. Current concepts in postpartum anemia management.
- Author
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Neef V, Choorapoikayil S, Hof L, Meybohm P, and Zacharowski K
- Subjects
- Humans, Female, Pregnancy, Anemia therapy, Anemia diagnosis, Anemia etiology, Iron therapeutic use, Iron administration & dosage, Postpartum Period, Puerperal Disorders therapy, Puerperal Disorders diagnosis, Puerperal Disorders etiology, Dietary Supplements, Iron Deficiencies diagnosis, Iron Deficiencies therapy, Anemia, Iron-Deficiency diagnosis, Anemia, Iron-Deficiency therapy, Anemia, Iron-Deficiency etiology
- Abstract
Purpose of Review: Postpartum anemia (PPA) is common in women after childbirth and affects about 50-80% of all women worldwide. Iron deficiency (ID) is the main cause for anemia and constitutes a potentially preventable condition with great impact on the mother's physical and mental condition after delivery. In most cases, PPA is associated with antenatal ID and peripartum blood losses. Numerous published studies confirmed the positive effect of PPA diagnosis and treatment., Recent Findings: Iron deficiency as well as iron deficiency anemia (IDA) are common in the postpartum period and represent significant health problems in women of reproductive age., Summary: Important movements towards early detection and therapy of postpartum anemia have been observed. However, postpartum anemia management is not implemented on a large scale as many healthcare professionals are not aware of the most recent findings in the field. Diagnosis and therapy of PPA, particularly iron supplementation in ID and IDA, has proven to be highly effective with a tremendous effect on women's wellbeing and outcome., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2024
- Full Text
- View/download PDF
4. Current concepts in the use of cell salvage in obstetrics.
- Author
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Neef V, Meybohm P, Zacharowski K, and Kranke P
- Subjects
- Humans, Pregnancy, Female, Postpartum Hemorrhage therapy, Erythrocyte Transfusion methods, Erythrocyte Transfusion adverse effects, Erythrocyte Transfusion standards, Blood Transfusion, Autologous methods, Blood Transfusion, Autologous adverse effects, Blood Transfusion, Autologous standards, Blood Loss, Surgical prevention & control, Embolism, Amniotic Fluid therapy, Embolism, Amniotic Fluid diagnosis, Obstetrics methods, Obstetrics trends, Obstetrics standards, Operative Blood Salvage methods, Operative Blood Salvage adverse effects
- Abstract
Purpose of Review: The worldwide leading cause of maternal death is severe maternal hemorrhage. Maternal hemorrhage can be profound leading to an entire loss of blood volume. In the past two decades, Patient Blood Management has evolved to improve patient's care and safety. In surgeries with increased blood loss exceeding 500 ml, the use of cell salvage is strongly recommended in order to preserve the patient's own blood volume and to minimize the need for allogeneic red blood cell (RBC) transfusion. In this review, recent evidence and controversies of the use of cell salvage in obstetrics are discussed., Recent Findings: Numerous medical societies as well as national and international guidelines recommend the use of cell salvage during maternal hemorrhage., Summary: Intraoperative cell salvage is a strategy to maintain the patient's own blood volume and decrease the need for allogeneic RBC transfusion. Historically, cell salvage has been avoided in the obstetric population due to concerns of iatrogenic amniotic fluid embolism (AFE) or induction of maternal alloimmunization. However, no definite case of AFE has been reported so far. Cell salvage is strongly recommended and cost-effective in patients with predictably high rates of blood loss and RBC transfusion, such as women with placenta accreta spectrum disorder. However, in order to ensure sufficient practical experience in a multiprofessional obstetric setting, liberal use of cell salvage appears advisable., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2024
- Full Text
- View/download PDF
5. Obstetric anesthesia from the beginning to the end: opportunities and challenges.
- Author
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Neef V
- Subjects
- Pregnancy, Female, Humans, Anesthesia, Obstetrical adverse effects, Labor, Obstetric, Anesthesiology
- Published
- 2023
- Full Text
- View/download PDF
6. Current concepts in preoperative anemia management in obstetrics.
- Author
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Wiesenack C, Meybohm P, Neef V, and Kranke P
- Subjects
- Pregnancy, Female, Humans, Iron therapeutic use, Anemia, Iron-Deficiency diagnosis, Anemia, Iron-Deficiency etiology, Anemia, Iron-Deficiency therapy, Obstetrics, Anemia diagnosis, Anemia etiology, Anemia therapy, Iron Deficiencies
- Abstract
Purpose of Review: The purpose of this article is to provide an overview of currently recommended treatment approaches for anemia during pregnancy, with a special focus on iron deficiency and iron deficiency anemia (IDA)., Recent Findings: As consistent patient blood management (PBM) guidelines in obstetrics are still lacking, recommendations regarding the timing of anemia screening and the treatment recommendations for iron deficiency and IDA during pregnancy are still controversial. Based on increasing evidence, early screening for anemia and iron deficiency should be recommended at the beginning of each pregnancy. To reduce maternal and fetal burden, any iron deficiency, even without anemia, should be treated as early as possible during pregnancy. While oral iron supplements administered every other day are the standard treatment in the first trimester, the use of intravenous iron supplements is increasingly suggested from the second trimester onwards., Summary: The treatment of anemia, and more specifically iron deficiency anemia during pregnancy, holds many possibilities for improvement. The fact that the period of risk is known well in advance and thus there is a long optimization phase is per se an ideal prerequisite for the best possible therapy of treatable causes of anemia. Standardization of recommendations and guidelines for screening and treatment of IDA in obstetrics is required for the future. In any case, a multidisciplinary consent is the precondition for a successfully implementation of anemia management in obstetrics to establish an approved algorithm easily enabling detection and treatment of IDA during pregnancy., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2023
- Full Text
- View/download PDF
7. Severe bleeding in the ICU.
- Author
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Rauer MJ, Neef V, and Berra L
- Subjects
- Hemoglobins analysis, Hemorrhage etiology, Hemorrhage therapy, Humans, Intensive Care Units, Anemia, Erythrocyte Transfusion
- Abstract
Purpose of Review: Severe bleeding events, which require blood transfusions, are a challenge faced by many critical care physicians on a daily basis. Current transfusion guidelines generally recommend rather strict transfusion thresholds and strategies, which can appear opposing to a patient in need for urgent transfusion at first sight. Moreover, applied guidelines are lacking evidence and specificity for the typical ICU patient population and its comorbidities. Transfusion decisions, which are pivotal for clinical outcome, are often unsatisfactorily based on hemoglobin levels only., Recent Findings: Recent publications generally support previous studies that a strict transfusion regimen is superior to a liberal one for the majority of cases. Newly developed and easily feasible techniques are currently in clinical trials and have the potential to become a valuable supplementation to hemoglobin-guided decision-making. In addition to the choice of the ideal transfusion strategy, physiological status and comorbidities were found to have a major impact on the outcome of severe bleedings in the ICU., Summary: The body of evidence for ICU-specific transfusion guidelines is scarce. Critical care physicians should properly evaluate their patient's comorbidities and consider extended point-of-care testing for transfusion decisions in indistinct anemic situations. A strict transfusion strategy should, however, be applied whenever possible., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF
8. Current concepts in the evaluation and management of preoperative anemia.
- Author
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Neef V, Choorapoikayil S, Piekarski F, Schlesinger T, Meybohm P, and Zacharowski K
- Subjects
- Blood Transfusion, Humans, Iron, Preoperative Care, Risk Factors, Anemia diagnosis, Anemia epidemiology, Anemia etiology
- Abstract
Purpose of Review: In the past years, patient blood management (PBM) has evolved to improve patient's care and safety. Anemia is one of the most common medical diseases in the world and is an independent risk factor for morbidity and mortality. Iron deficiency is the main cause for anemia and constitutes a potentially preventable condition with a great impact on surgical outcome. However, preoperative anemia management is not yet established in most hospitals. Changing workflows and re-thinking is challenging. Numerous published studies confirmed the positive effect of preoperative anemia diagnosis and treatment recently., Recent Findings: Iron supplementation in iron-deficient anemic (IDA) patients reduce the need for allogenic blood transfusion thereby improving perioperative outcome., Summary: Since the introduction of PBM programs, important movements towards early detection and therapy of preoperative anemia have been observed. However, preoperative anemia management is not implemented on a large scale as many healthcare professionals are not aware of the most recent findings in the field. Preoperative anemia management, particularly iron supplementation in IDA patients, has proven to be highly effective and has a tremendous effect on patient safety and outcome., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF
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