Effect of patient blood management system and feedback programme on appropriateness of transfusion: An experience of Asia's first Bloodless Medicine Center on a hospital basis

2020 ◽  
Author(s):  
Hyeon Ju Shin ◽  
Jong Hun Kim ◽  
Yujin Park ◽  
Ki Hoon Ahn ◽  
Jae Seung Jung ◽  
...  
Keyword(s):  
Management System ◽  
Patient Blood Management ◽  
Blood Management

Patient Blood Management in der Orthopädie und Unfallchirurgie

2020 ◽  
Vol 15 (03) ◽  
pp. 239-255
Author(s):  
Lea Valeska Blum ◽  
Hendrik Kohlhof ◽  
Dieter Wirtz ◽  
Kai Zacharowski ◽  
Patrick Meybohm
Keyword(s):  
Patient Blood Management ◽  
Blood Management ◽  
Orthopädie Und Unfallchirurgie

Patient Blood Management – Der präoperative Patient

2014 ◽  
Vol 49 (04) ◽  
pp. 246-254 ◽  
Author(s):  
Markus Müller ◽  
Dania Fischer ◽  
Ulrich Stock ◽  
Christof Geisen ◽  
Björn Steffen ◽  
...  
Keyword(s):  
Patient Blood Management ◽  
Blood Management

scholarly journals Seeking Strategies to Optimize Blood Utilization: The Preliminary Experience with Implementing a Patient Blood Management Program in a Greek Tertiary Hospital

2021 ◽  
Vol 10 (10) ◽  
pp. 2141
Author(s):  
Aimilia Tsante ◽  
Anastasia Papandreadi ◽  
Andreas G. Tsantes ◽  
Elias Kyriakou ◽  
Panagiota Douramani ◽  
...  
Keyword(s):  
Tertiary Hospital ◽  
Management Program ◽  
Transfusion Practice ◽  
Patient Blood Management ◽  
Medical Patients ◽  
Blood Management ◽  
Transfusion Threshold ◽  
Restrictive Transfusion ◽  
Implementation Period ◽  
Blood Utilization

Objectives: Our aim was to assess blood utilization after implementation of a patient blood management (PBM) program in a Greek tertiary hospital. Methods: An electronic transfusion request form and a prospective audit of transfusion practice were implemented. After the one-year implementation period, a retrospective review was performed to assess transfusion practice in medical patients. Results: Pre-PBM, a total of 9478 RBC units were transfused (mean: 1.75 units per patient) compared with 9289 transfused units (mean: 1.57 units per patient) post-PBM. Regarding the post-PBM period, the mean hemoglobin (Hb) level of the 3099 medical patients without comorbidities transfused was 7.19 ± 0.79 gr/dL. Among them, 2065 (66.6%) had Hb levels >7.0 gr/dL, while 167 (5.3%) had Hb levels >8.0 gr/dL. In addition, 331 (25.3%) of the transfused patients with comorbidities had Hb >8.0 gr/dL. The Hb transfusion thresholds significantly differed across the clinics (p < 0.001), while 21.8% of all medical non-bleeding patients received more than one RBC unit transfusion. Conclusion: A poor adherence with the restrictive transfusion threshold of 7.0 gr/dL was observed. The adoption of a less strict threshold might be a temporary step to allow physicians to become familiar with the program and be informed on the safety and advantages of the restrictive transfusion strategy.

Patient Blood Management in Elective Total Hip- and Knee-replacement Surgery (Part 2)

2014 ◽  
Vol 120 (4) ◽  
pp. 852-860 ◽  
Author(s):  
Cynthia So-Osman ◽  
Rob G. H. H. Nelissen ◽  
Ankie W. M. M. Koopman-van Gemert ◽  
Ewoud Kluyver ◽  
Ruud G. Pöll ◽  
...  
Keyword(s):  
Knee Replacement ◽  
Control Group ◽  
Transfusion Rate ◽  
Cell Saver ◽  
Patient Blood Management ◽  
Blood Management ◽  
Knee Replacement Surgery ◽  
Total Hip ◽  
Replacement Surgery ◽  
Preoperative Hemoglobin

Abstract Background: Patient blood management is introduced as a new concept that involves the combined use of transfusion alternatives. In elective adult total hip- or knee-replacement surgery patients, the authors conducted a large randomized study on the integrated use of erythropoietin, cell saver, and/or postoperative drain reinfusion devices (DRAIN) to evaluate allogeneic erythrocyte use, while applying a restrictive transfusion threshold. Patients with a preoperative hemoglobin level greater than 13 g/dl were ineligible for erythropoietin and evaluated for the effect of autologous blood reinfusion. Methods: Patients were randomized between autologous reinfusion by cell saver or DRAIN or no blood salvage device. Primary outcomes were mean intra- and postoperative erythrocyte use and proportion of transfused patients (transfusion rate). Secondary outcome was cost-effectiveness. Results: In 1,759 evaluated total hip- and knee-replacement surgery patients, the mean erythrocyte use was 0.19 (SD, 0.9) erythrocyte units/patient in the autologous group (n = 1,061) and 0.22 (0.9) erythrocyte units/patient in the control group (n = 698) (P = 0.64). The transfusion rate was 7.7% in the autologous group compared with 8.3% in the control group (P = 0.19). No difference in erythrocyte use was found between cell saver and DRAIN groups. Costs were increased by €298 per patient (95% CI, 76 to 520). Conclusion: In patients with preoperative hemoglobin levels greater than 13 g/dl, autologous intra- and postoperative blood salvage devices were not effective as transfusion alternatives: use of these devices did not reduce erythrocyte use and increased costs.

scholarly journals Patient Blood Management

2016 ◽  
Vol 264 (2) ◽  
pp. 212-213 ◽  
Author(s):  
Donat R. Spahn
Keyword(s):  
Patient Blood Management ◽  
Blood Management

scholarly journals Präoperative Vorbereitung: Patient Blood Management – Was ist optimal?

2017 ◽  
Vol 52 (05) ◽  
pp. 326-340 ◽  
Author(s):  
Patrick Meybohm ◽  
Markus Müller ◽  
Kai Zacharowski
Keyword(s):  
Patient Blood Management ◽  
Blood Management ◽  
Perioperative Morbidität ◽  
Präoperative Vorbereitung ◽  
Präoperative Anämie

ZusammenfassungPatient Blood Management (PBM) fokussiert auf ein umfassendes Anämiemanagement, die Minimierung (unnötiger) iatrogener Blutverluste und die Ausschöpfung der natürlichen Anämietoleranz mit rationalem Einsatz von Erythrozytenkonzentrat-Transfusionen. Im Mittelpunkt des aktuellen Beitrags stehen die in der präoperativen Phase entscheidenden PBM-Komponenten: Management einer Anämie, prätransfusionelle Vorbereitungen und Management von Antikoagulanzien. Die präoperative Anämie ist ein unabhängiger Risikofaktor für eine erhöhte perioperative Morbidität und Sterblichkeit. Zum frühestmöglichen Zeitpunkt sollte daher vor elektiven Eingriffen die Ursachen der Anämie abgeklärt und bei behandelbaren Ursachen der Anämie eine spezifische Behandlung eingeleitet werden. Die präoperative prätransfusionelle Analytik sollte in Abhängigkeit von der Transfusionswahrscheinlichkeit (und dem Ausgangshämoglobinwert) einem Stufenkonzept folgen und aktuelle hausinterne Daten berücksichtigen. Im Umgang mit (oralen) Antikoagulanzien sollte bereits in der präoperativen Phase eine individuelle Risikostratifizierung erfolgen. Anhand des individuellen Blutungs- und Thromboembolierisikos wird sodann entschieden, ob die Medikation fortgeführt, pausiert oder überbrückt werden muss. Ohne klar definierte Verantwortlichkeiten im präoperativen PBM-Team, Kommunikation und Schulung aller Beteiligten ist langfristig kein Erfolg des präoperativen PBM-Programms zu erwarten.

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