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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">bloodjour</journal-id><journal-title-group><journal-title xml:lang="ru">Гематология и трансфузиология</journal-title><trans-title-group xml:lang="en"><trans-title>Russian journal of hematology and transfusiology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">0234-5730</issn><issn pub-type="epub">2411-3042</issn><publisher><publisher-name>ООО Издательский дом «Практика»</publisher-name></publisher></journal-meta><article-meta><article-id custom-type="elpub" pub-id-type="custom">bloodjour-274</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КЛИНИЧЕСКИЕ РЕКОМЕНДАЦИИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CLINICAL RECOMMENDATIONS</subject></subj-group></article-categories><title-group><article-title>Руководство по лечению тяжелого периоперационного кровотечения: рекомендации Европейского общества анестезиологов</article-title><trans-title-group xml:lang="en"><trans-title>Management of severe perioperative bleeding. Guidelines from the European Society of Anaesthesiology</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Kozek-Langenecker</surname><given-names>S. A.</given-names></name><name name-style="western" xml:lang="en"><surname>Kozek-Langenecker</surname><given-names>S. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Sibylle A. Kozek-Langenecker</p></bio><bio xml:lang="en"><p>Sibylle A. Kozek-Langenecker</p></bio></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ahmed</surname><given-names>А. B.</given-names></name><name name-style="western" xml:lang="en"><surname>Ahmed</surname><given-names>A. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Aamer B. Ahmed</p></bio><bio xml:lang="en"><p>Aamer B. Ahmed</p></bio></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Afshari</surname><given-names>A.</given-names></name><name name-style="western" xml:lang="en"><surname>Afshari</surname><given-names>A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Arash Afshari</p></bio><bio xml:lang="en"><p>Arash Afshari</p></bio></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Albaladejo</surname><given-names>P.</given-names></name><name name-style="western" xml:lang="en"><surname>Albaladejo</surname><given-names>P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Pierre Albaladejo</p></bio><bio xml:lang="en"><p>Pierre Albaladejo</p></bio></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Aldecoa</surname><given-names>C.</given-names></name><name name-style="western" xml:lang="en"><surname>Aldecoa</surname><given-names>C.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Cesar Aldecoa</p></bio><bio xml:lang="en"><p>Cesar Aldecoa</p></bio></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Barauskas</surname><given-names>G.</given-names></name><name name-style="western" xml:lang="en"><surname>Barauskas</surname><given-names>G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Guidrius Barauskas</p><p> </p></bio><bio xml:lang="en"><p>Guidrius Barauskas</p></bio></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Robertis</surname><given-names>E. De</given-names></name><name name-style="western" xml:lang="en"><surname>Robertis</surname><given-names>E. De</given-names></name></name-alternatives><bio xml:lang="ru"><p>Edoardo De Robertis</p></bio><bio xml:lang="en"><p>Edoardo De Robertis</p></bio></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Faraoni</surname><given-names>D.</given-names></name><name name-style="western" xml:lang="en"><surname>Faraoni</surname><given-names>D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>David Faraoni</p></bio><bio xml:lang="en"><p>David Faraoni</p></bio></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Filipescu</surname><given-names>D. C.</given-names></name><name name-style="western" xml:lang="en"><surname>Filipescu</surname><given-names>D. C.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Daniela C. Filipescu</p></bio><bio xml:lang="en"><p>Daniela C. Filipescu</p></bio></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Fries</surname><given-names>D.</given-names></name><name name-style="western" xml:lang="en"><surname>Fries</surname><given-names>D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Dietmar Fries</p></bio><bio xml:lang="en"><p>Dietmar Fries</p></bio></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Haas</surname><given-names>T.</given-names></name><name name-style="western" xml:lang="en"><surname>Haas</surname><given-names>T.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Thorsten Haas</p></bio><bio xml:lang="en"><p>Thorsten Haas</p></bio></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Jacob</surname><given-names>M.</given-names></name><name name-style="western" xml:lang="en"><surname>Jacob</surname><given-names>M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Matthias Jacob</p></bio><bio xml:lang="en"><p>Matthias Jacob</p></bio></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Lance´</surname><given-names>M. D.</given-names></name><name name-style="western" xml:lang="en"><surname>Lance´</surname><given-names>M. D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Marcus D. Lance´</p></bio><bio xml:lang="en"><p>Marcus D. Lance´</p></bio></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Pitarch</surname><given-names>J. V.L.</given-names></name><name name-style="western" xml:lang="en"><surname>Pitarch</surname><given-names>J. V.L.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Juan V.L. Pitarch</p></bio><bio xml:lang="en"><p>Juan V.L. Pitarch</p></bio></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Mallett</surname><given-names>S.</given-names></name><name name-style="western" xml:lang="en"><surname>Mallett</surname><given-names>S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Susan Mallett</p></bio><bio xml:lang="en"><p>Susan Mallett</p></bio></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Meier</surname><given-names>J.</given-names></name><name name-style="western" xml:lang="en"><surname>Meier</surname><given-names>J.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Jens Meier</p></bio><bio xml:lang="en"><p>Jens Meier</p></bio></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Molnar</surname><given-names>Z. L.</given-names></name><name name-style="western" xml:lang="en"><surname>Molnar</surname><given-names>Z. L.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Zsolt L. Molnar</p></bio><bio xml:lang="en"><p>Zsolt L. Molnar</p></bio></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Rahe-Meyer</surname><given-names>N.</given-names></name><name name-style="western" xml:lang="en"><surname>Rahe-Meyer</surname><given-names>N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Niels Rahe-Meyer</p></bio><bio xml:lang="en"><p>Niels Rahe-Meyer</p></bio></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Samama</surname><given-names>Ch. M.</given-names></name><name name-style="western" xml:lang="en"><surname>Samama</surname><given-names>Ch. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Charles M. Samama</p></bio><bio xml:lang="en"><p>Charles M. Samama</p></bio></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Stensballe</surname><given-names>J.</given-names></name><name name-style="western" xml:lang="en"><surname>Stensballe</surname><given-names>J.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Jakob Stensballe</p></bio><bio xml:lang="en"><p>Jakob Stensballe</p></bio></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Van der Linden</surname><given-names>P. J.F.</given-names></name><name name-style="western" xml:lang="en"><surname>Van der Linden</surname><given-names>P. J.F.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Philippe J.F. Van der Linden</p></bio><bio xml:lang="en"><p>Philippe J.F. Van der Linden</p></bio></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Wikkelsø</surname><given-names>A.</given-names></name><name name-style="western" xml:lang="en"><surname>Wikkelsø</surname><given-names>A. J.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Anne J. Wikkelsø</p></bio><bio xml:lang="en"><p>Anne J. Wikkelsø</p></bio></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Wouters</surname><given-names>P.</given-names></name><name name-style="western" xml:lang="en"><surname>Wouters</surname><given-names>P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Patrick Wouters</p></bio><bio xml:lang="en"><p>Patrick Wouters</p></bio></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Wyffels</surname><given-names>P.</given-names></name><name name-style="western" xml:lang="en"><surname>Wyffels</surname><given-names>P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Piet Wyffels</p></bio><bio xml:lang="en"><p>Piet Wyffels</p></bio></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Zacharowski</surname><given-names>K.</given-names></name><name name-style="western" xml:lang="en"><surname>Zacharowski</surname><given-names>K.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Kai Zacharowski</p></bio><bio xml:lang="en"><p>Kai Zacharowski</p></bio></contrib></contrib-group><pub-date pub-type="collection"><year>2021</year></pub-date><pub-date pub-type="epub"><day>18</day><month>05</month><year>2021</year></pub-date><volume>66</volume><issue>1</issue><fpage>88</fpage><lpage>160</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Kozek-Langenecker S.A., Ahmed А.B., Afshari A., Albaladejo P., Aldecoa C., Barauskas G., Robertis E.D., Faraoni D., Filipescu D.C., Fries D., Haas T., Jacob M., Lance´ M.D., Pitarch J.V., Mallett S., Meier J., Molnar Z.L., Rahe-Meyer N., Samama C.M., Stensballe J., Van der Linden P.J., Wikkelsø A.J., Wouters P., Wyffels P., Zacharowski K., 2021</copyright-statement><copyright-year>2021</copyright-year><copyright-holder xml:lang="ru">Kozek-Langenecker S.A., Ahmed А.B., Afshari A., Albaladejo P., Aldecoa C., Barauskas G., Robertis E.D., Faraoni D., Filipescu D.C., Fries D., Haas T., Jacob M., Lance´ M.D., Pitarch J.V., Mallett S., Meier J., Molnar Z.L., Rahe-Meyer N., Samama C.M., Stensballe J., Van der Linden P.J., Wikkelsø A., Wouters P., Wyffels P., Zacharowski K.</copyright-holder><copyright-holder xml:lang="en">Kozek-Langenecker S.A., Ahmed A.B., Afshari A., Albaladejo P., Aldecoa C., Barauskas G., Robertis E.D., Faraoni D., Filipescu D.C., Fries D., Haas T., Jacob M., Lance´ M.D., Pitarch J.V., Mallett S., Meier J., Molnar Z.L., Rahe-Meyer N., Samama C.M., Stensballe J., Van der Linden P.J., Wikkelsø A.J., Wouters P., Wyffels P., Zacharowski K.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.htjournal.ru/jour/article/view/274">https://www.htjournal.ru/jour/article/view/274</self-uri><abstract><p>Выбор наиболее подходящей стратегии лечения пациентов с  периоперационным кровотечением  — сложная и многоступенчатая задача. Изначально необходимо определить, существует ли у пациента повышенный риск развития периоперационного кровотечения. Затем, в целях профилактики развития кровотечения, необходимо провести предоперационную коррекцию анемии, а также стабилизацию макроциркуляции и микроциркуляции, чтобы создать оптимальные условия для переносимости кровотечения. Наконец, для уменьшения кровопотери вследствие развития интраоперационных и послеоперационных кровотечений, во избежание развития осложнений или смертельного исхода должны быть применены методы целевого вмешательства. В настоящем обновлении руководства представлен обзор наиболее актуальной информации, которая может помочь медицинскому персоналу улучшить стратегию терапии таких пациентов. Для поиска информации в данном обновлении были использованы электронные базы данных, составленные на всех языках мира, начиная с 2011 г. или 2012 г. (в зависимости от условий поиска) и заканчивая 2015 г. В ходе данного поиска были отобраны 18 334 статьи. В поисках новых методов были изучены все статьи, а также пересмотрены существующие рекомендации 2013 г. В рекомендациях 2013 г. были отредактированы некоторые формулировки, изменена градация рекомендаций по степени значимости, а также были добавлены новые рекомендации. Предварительная версия рекомендаций была опубликована на сайте Европейского общества анестезиологов (European Society of Anaesthesiology — ESA) и была доступна для рассмотрения в течение четырех недель. Все комментарии были учтены, а соответствующие поправки внесены в данную версию.</p></abstract><trans-abstract xml:lang="en"><p>.</p></trans-abstract></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">De Robertis E., Longrois D. To streamline the guideline challenge: The European Society of Anaesthesiology policy on guidelines development. 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