Insights from an Expert: Prof. Kietaibl's key messages on the Severe Bleeding guidelines

We were privileged to have the opportunity to interview with Prof. Prof. Sibylle Kietaibl, an esteemed professional whose involvement with the European Society of Anaesthesiology and Intensive Care (ESAIC) has significantly contributed to the advancement of the field, currecntly Head of the Department of Anaesthesia and Intensive Care – Evangelical Hospital Vienna, Austria.

Prof. Kietaibl’s journey with ESAIC has been fueled by a genuine passion for knowledge exchange and collaboration. Her active participation in various committees and task forces has demonstrated her dedication to improving patient care and safety. Notably, she has played a pivotal role in the development of the “Management of severe peri-operative bleeding: Guidelines from the European Society of Anaesthesiology and Intensive Care: Second update 2022,” showcasing her expertise and commitment to shaping best practices in the field. In this interview, Prof. Kietaibl shares her experiences, areas of interest, and insights into the future of anaesthesiology. We are grateful for her valuable contributions and expertise, which continue to elevate the standards of patient care.

Prof. Kiataibl, what led to your involvement with ESAIC?

For decades, I have been attending the Euroanaesthesia Congress, which have consistently provided me with high-quality lectures and valuable knowledge transfer. Through networking with international experts in my areas of interest, it was only natural that I became involved in ESAIC subcommittees and guidelines task forces. The opportunity to collaborate with altruistic professionals dedicated to supporting colleagues and improving patient safety greatly appealed to me.

Could you please share your experience and involvement in various ESAIC committees and task forces?

My experience with ESAIC committees and task forces has been incredibly positive. Within our society, countless professionals selflessly dedicate their time and energy to enhancing patient care and safety through various means. Even during the COVID-19 pandemic, we successfully delivered fruitful ESAIC projects, a testament to the exceptional communication skills and dedication of our collaborators.

What are your areas of interest?

My primary areas of interest revolve around bleeding and anaemia management, as well as patient preference management. These topics play crucial roles in ensuring optimal patient outcomes and improving the quality of care provided.

What are the main takeaways or key messages from the Severe Bleeding guidelines?

The Severe Bleeding guidelines consist of 19 recommendations and 4 reconfirmed statements for different patient groups and elective surgical scenarios where severe bleeding may occur. The guidelines address two main clinical questions:

1. Which patients should be optimised before surgery, and how? This involves identifying and correcting pre-existing anaemia preoperatively, as well as adjusting antithrombotic medications.
2. How should intra- and postoperative bleeding be treated, and anaemia corrected? Surgical bleeding events should be managed through surgical measures, while acquired coagulopathic bleeding requires individualised correction of the underlying pathomechanisms.

Could you please provide more information about the concept of patient blood management?

Patient blood management aims to reduce perioperative blood loss and minimise the need for allogeneic blood products by implementing several strategies, such as:

• Screening for and treating perioperative anaemia
• Minimising blood loss
• Applying restrictive transfusion triggers
• Conserving and boosting the patient’s own blood resources

What do you foresee for the future of this guideline?

We hope that the content of the second update of the ESAIC guidelines will be effectively implemented into clinical practice across Europe. Furthermore, a regular update is anticipated in approximately 3-5 years.

Could you please provide a brief overview of the main focus of your presentation at Euroanaesthesia this year?

My presentation at Euroanaesthesia focuses on the perioperative management of patients on direct oral anticoagulants who are scheduled for regional anaesthesia. Specifically, I will be addressing the ESAIC/ESRA guidelines on regional anaesthesia in patients taking antithrombotic drugs, which were published in 2022.

What aspect of the Euroanaesthesia congress do you enjoy the most and why?

The Euroanaesthesia congress offers me the privilege of reconnecting with colleagues in person, which is particularly meaningful given the recent prevalence of virtual or hybrid meetings. Additionally, I deeply appreciate the opportunity to listen to high-quality lectures spanning various fields within the broad discipline of Anaesthesiology and Intensive Care Medicine, as it allows for a focused brush-up of knowledge.

In conclusion, Prof. Kietaibl’s involvement with ESAIC has been driven by a passion for knowledge exchange and collaboration. Her active participation in committees and task forces showcases her dedication to advancing the field of anaesthesiology and intensive care. One notable accomplishment is her authorship of the “Management of severe peri-operative bleeding: Guidelines from the European Society of Anaesthesiology and Intensive Care: Second update 2022,” which demonstrates her expertise and contribution to shaping best practices in patient care. Additionally, her focus on the perioperative management of patients on antithrombotic drugs highlights her commitment to ensuring optimal outcomes and safety.

We would like to express our sincere gratitude to Prof. Kietaibl for taking the time to share her insights and expertise for this article. Her valuable contributions have enriched our understanding of these important topics and will undoubtedly have a positive impact on the field of anaesthesiology.