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https://www.readbyqxmd.com/read/29159367/promoting-high-value-practice-by-reducing-unnecessary-transfusions-with-a-patient-blood-management-program
#1
Divyajot Sadana, Ariella Pratzer, Lauren J Scher, Harry S Saag, Nicole Adler, Frank M Volpicelli, Moises Auron, Steven M Frank
Although blood transfusion is a lifesaving therapy for some patients, transfusion has been named 1 of the top 5 overused procedures in US hospitals. As unnecessary transfusions only increase risk and cost without providing benefit, improving transfusion practice is an effective way of promoting high-value care. Most high-quality clinical trials supporting a restrictive transfusion strategy have been published in the past 5 to 10 years, so the value of a successful patient blood management program has only recently been recognized...
November 20, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29099397/implementation-of-a-blood-management-program-at-a-tertiary-care-hospital-effect-on-transfusion-practices-and-clinical-outcomes-among-patients-undergoing-surgery
#2
Faiz Gani, Marcelo Cerullo, Aslam Ejaz, Pranjal B Gupta, Vincent M Demario, Fabian M Johnston, Steven M Frank, Timothy M Pawlik
BACKGROUND: Patient blood management (PBM) programs represent a perioperative bundle of care that aim to reduce or eliminate unnecessary transfusions. OBJECTIVE: To evaluate the impact of a PBM program on transfusion practices and clinical outcomes at a single surgical department at a tertiary care hospital in the United States. METHODS: This pre-post, cross-sectional study was performed using data from 17,114 patients undergoing gastrointestinal surgery between 2010 and 2013...
November 2, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29090267/perioperative-patient-blood-management-programme-multidisciplinary-recommendations-from-the-patient-blood-management-initiative-group
#3
Daniela Filipescu, Răzvan Bănăţeanu, Mircea Beuran, Traean Burcoş, Dan Corneci, Dan Cristian, Mircea Diculescu, Alina Dobrotă, Gabriela Droc, Dănuţ Isacoff, Doina Goşa, Ioana Grinţescu, Anca Lupu, Liliana Mirea, Corina Posea, Oana Stanca, Mihai Ştefan, Dana Tomescu, Cristina Tudor, Daniela Ungureanu, Gabriel Mircescu
Patients with untreated anaemia or iron deficiency who undergo surgical procedures have an increased risk for mortality and morbidity. Patient Blood Management programmes address this issue worldwide and try to improve patient outcomes through a complex set of measures targeting anaemia correction, minimisation of bleeding and improvement of anaemia tolerance, in all phases of perioperative care. The Patient Blood Management Initiative Group is a multidisciplinary team of physicians from specialties including anaesthesiology, nephrology, surgery, orthopaedics, haematology, gastroenterology and transfusion medicine...
October 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/29082529/patient-blood-management-knowledge-and-practice-among-clinicians-from-seven-european-university-hospitals-a%C3%A2-multicentre-survey
#4
P M Manzini, A M Dall'Omo, S D'Antico, A Valfrè, K Pendry, A Wikman, D Fischer, D Borg-Aquilina, S Laspina, E C M van Pampus, M van Kraaij, M T Bruun, J Georgsen, J Grant-Casey, P S Babra, M F Murphy, G Folléa, K Aranko
BACKGROUND AND OBJECTIVES: The aim of this survey was to evaluate the knowledge about Patient Blood Management (PBM) principles and practices amongst clinicians working in seven European hospitals participating in a European Blood Alliance (EBA) project. MATERIALS AND METHODS: A web-based questionnaire was sent to 4952 clinicians working in medical, surgery and anaesthesiology disciplines. The responses were analysed, and the overall results as well as a comparison between hospitals are presented...
October 29, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/29076249/expanding-access-to-transfusion-medicine-and-improving-practice-guidelines-patient-blood-management-protocols-and-products
#5
EDITORIAL
D J Roberts
No abstract text is available yet for this article.
October 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/29064875/perioperative-patient-blood-management-to-improve-outcomes
#6
Neel Desai, Nick Schofield, Toby Richards
Anemia is common in elective surgery and is an independent risk factor for morbidity and mortality. Historical management of anemia has focused on the use of allogeneic blood transfusion but this in itself is not without risk. It too has been independently associated with morbidity and mortality, let alone the costs and relative shortage of this resource. In recognition of this, patient blood management (PBM) shifts the focus from the product to the patient and views the patient's own blood as a resource that should be conserved and managed appropriately as a standard of care...
October 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29050713/is-preoperative-fibrinogen-testing-associated-with-total-blood-loss-in-adolescent-idiopathic-scoliosis-correction
#7
Matthew J Geck, Devender Singh, Holly Gunn, John K Stokes, Eeric Truumees
STUDY DESIGN: Retrospective analysis. OBJECTIVE: This study sought to investigate the potential association between preoperative fibrinogen, bleeding, and transfusion requirements in adolescent idiopathic scoliosis (AIS) corrections. SUMMARY OF BACKGROUND DATA: Blood loss after major spinal reconstruction increases the risks and costs of surgery. Preoperative fibrinogen levels may predict intra- and postoperative blood loss. METHODS: Data were collected from clinic charts and hospital medical records of all 110 of a single surgeon's consecutive AIS patients undergoing greater than three-level deformity correction surgeries from January 2011 to December 2013...
November 2017: Spine Deformity
https://www.readbyqxmd.com/read/29029990/2017-eacts-eacta-guidelines-on-patient-blood-management-for-adult-cardiac-surgery
#8
REVIEW
Christa Boer, Michael I Meesters, Milan Milojevic, Umberto Benedetto, Daniel Bolliger, Christian von Heymann, Anders Jeppsson, Andreas Koster, Ruben L Osnabrugge, Marco Ranucci, Hanne Berg Ravn, Alexander B A Vonk, Alexander Wahba, Domenico Pagano, Moritz W V Wyler von Ballmoos, Mate Petricevic, Arie Pieter Kappetein, Miguel Sousa-Uva, Georg Trummer, Peter M Rosseel, Michael Sander, Pascal Colson, Adrian Bauer
Authors/Task Force Members: Christa Boer (EACTA Chairperson)(Netherlands), Michael I. Meesters (Netherlands), Milan Milojevic (Netherlands), Umberto Benedetto (UK), Daniel Bolliger (Switzerland), Christian von Heymann (Germany), Anders Jeppsson (Sweden), Andreas Koster (Germany), Ruben L. Osnabrugge (Netherlands), Marco Ranucci (Italy), Hanne Berg Ravn (Denmark), Alexander B.A. Vonk (Netherlands), Alexander Wahba (Norway), Domenico Pagano (EACTS Chairperson)(UK), Document Reviewers: Moritz W.V. Wyler von Ballmoos (USA), Mate Petricevic (Croatia), Arie Pieter Kappetein (Netherlands), Miguel Sousa-Uva (Portugal), Georg Trummer (Germany), Peter M...
September 30, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29029100/2017-eacts-eacta-guidelines-on-patient-blood-management-for-adult-cardiac-surgery-the-task-force-on-patient-blood-management-for-adult-cardiac-surgery-of-the-european-association-for-cardio-thoracic-surgery-eacts-and-the-european-association-of-cardiothoracic
#9
Domenico Pagano, Milan Milojevic, Michael I Meesters, Umberto Benedetto, Daniel Bolliger, Christian von Heymann, Anders Jeppsson, Andreas Koster, Ruben L Osnabrugge, Marco Ranucci, Hanne Berg Ravn, Alexander B A Vonk, Alexander Wahba, Christa Boer, Moritz W V Wyler von Ballmoos, Mate Petricevic, Arie Pieter Kappetein, Miguel Sousa-Uva, Georg Trummer, Peter M Rosseel, Michael Sander, Pascal Colson, Adrian Bauer
No abstract text is available yet for this article.
October 3, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28991109/patient-blood-management-in-pediatric-cardiac-surgery-a-review
#10
Jill M Cholette, David Faraoni, Susan M Goobie, Victor Ferraris, Nabil Hassan
Efforts to reduce blood product transfusions and adopt blood conservation strategies for infants and children undergoing cardiac surgical procedures are ongoing. Children typically receive red blood cell and coagulant blood products perioperatively for many reasons, including developmental alterations of their hemostatic system, and hemodilution and hypothermia with cardiopulmonary bypass that incites inflammation and coagulopathy and requires systemic anticoagulation. The complexity of their surgical procedures, complex cardiopulmonary interactions, and risk for inadequate oxygen delivery and postoperative bleeding further contribute to blood product utilization in this vulnerable population...
October 5, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28990242/blood-utilization-in-revision-versus-first-time-cardiac-surgery-an-update-in-the-era-of-patient-blood-management
#11
Nadia B Hensley, Megan P Kostibas, William W Yang, Todd C Crawford, Kaushik Mandal, Pranjal B Gupta, Steven M Frank, Charles H Brown
BACKGROUND: Relative to first-time (primary) cardiac surgery, revision cardiac surgery is associated with increased transfusion requirements, but studies comparing these cohorts were performed before patient blood management (PBM) and blood conservation measures were commonplace. The current study was performed as an update to determine if this finding is still evident in the PBM era. STUDY DESIGN AND METHODS: Primary and revision cardiac surgery cases were compared in a retrospective database analysis at a single tertiary care referral center...
October 8, 2017: Transfusion
https://www.readbyqxmd.com/read/28978859/patient-blood-management-and-transfusion-therapy-for-hemostasis
#12
Koji Yamamoto
Restrictive transfusion is the most common and appropriate treatment for patients with bleeding disorders because it is associated with better prognosis. However, hematologists are not familiar with the indication for and effect of using fresh frozen plasma (FFP) for transfusions, which has been inappropriately used to date. FFP should not be transfused for preventing bleeding or improving coagulation test results (i.e., PT and APTT). Instead, FFP transfusion should be performed to manage hemostasis, based on the fibrinogen levels of <150 mg/dl in patients' plasmas...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28970674/factors-influencing-transfusion-requirement-in-patients-undergoing-first-time-elective-coronary-artery-bypass-graft-surgery
#13
Ailin Mazuita Mazlan, Yasmin Ayob, Abd Rahim Hussein, Thiru Kumar Namasiwayam, Wan Mohd Zahiruddin Wan Mohammad
CONTEXT: Coronary artery bypass graft (CABG) operation is associated with high frequency of allogeneic blood transfusion due to the acquired hemostatic challenges in patients undergoing CABG. However, allogeneic blood transfusion carries risks of infection, adverse reaction, and mortality as well as prolonged hospital stay and increased hospital cost. It is important to identify patients who require blood transfusion to mitigate their risk factors and reduce the chance of exposure to allogeneic blood...
July 2017: Asian Journal of Transfusion Science
https://www.readbyqxmd.com/read/28969331/optimal-patient-blood-management-in-cardiac-surgery-using-viscoelastic-point-of-care-testing-response-to-routine-use-of-viscoelastic-blood-tests-for-diagnosis-and-treatment-of-coagulopathic-bleeding-in-cardiac-surgery-updated-systematic-review-and-meta-analysis
#14
https://www.readbyqxmd.com/read/28969306/the-acta-port-score-for-predicting-perioperative-risk-of-blood-transfusion-for-adult-cardiac-surgery
#15
A A Klein, T Collier, J Yeates, L F Miles, S N Fletcher, C Evans, T Richards
Background: A simple and accurate scoring system to predict risk of transfusion for patients undergoing cardiac surgery is lacking. Methods: We identified independent risk factors associated with transfusion by performing univariate analysis, followed by logistic regression. We then simplified the score to an integer-based system and tested it using the area under the receiver operator characteristic (AUC) statistic with a Hosmer-Lemeshow goodness-of-fit test. Finally, the scoring system was applied to the external validation dataset and the same statistical methods applied to test the accuracy of the ACTA-PORT score...
September 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28965799/multifactorial-risk-index-for-prediction-of-intraoperative-blood-transfusion-in-endovascular-aneurysm-repair
#16
Eitezaz Mahmood, Robina Matyal, Ariel Mueller, Feroze Mahmood, Avery Tung, Mario Montealegre-Gallegos, Marc Schermerhorn, Sajid Shahul
BACKGROUND: In some institutions, the current blood ordering practice does not discriminate minimally invasive endovascular aneurysm repair (EVAR) from open procedures, with consequent increasing costs and likelihood of blood product wastage for EVARs. This limitation in practice can possibly be addressed with the development of a reliable prediction model for transfusion risk in EVAR patients. We used the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database to create a model for prediction of intraoperative blood transfusion occurrence in patients undergoing EVAR...
September 28, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28959145/the-use-of-intraoperative-cell-salvage-in-urologic-oncology
#17
Matthew C Ferroni, Andres F Correa, Timothy D Lyon, Benjamin J Davies, Michael C Ost
Intraoperative cell salvage (IOCS) has been used in urologic surgery for over 20 years to manage intraoperative blood loss and effectively minimize the need for allogenic blood transfusion. Concerns about viability of transfused erythrocytes and potential dissemination of malignant cells have been addressed in the urologic literature. We present a comprehensive review of the use of IOCS in urologic oncologic surgery. IOCS has been shown to preserve the integrity of erythrocytes during processing and effectively provides cell filtration to mitigate the risk of tumor dissemination...
2017: Reviews in Urology
https://www.readbyqxmd.com/read/28940786/cornerstones-of-patient-blood-management-in-surgery
#18
REVIEW
A Butcher, T Richards
Pre-operative anaemia and perioperative red blood cell transfusion carry significant consequence when it comes to surgical outcomes. The establishment of patient-centred clinical pathways has been designed to harness and endorse good transfusion practice, termed the three pillars of patient blood management (PBM). These focus on the timely and appropriate management of anaemia, prevention of blood loss and restrictive transfusion where appropriate. This article reviews the current evidence and ongoing research in the field of PBM in surgery...
September 22, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/28921529/metastatic-spine-tumor-surgery-does-perioperative-blood-transfusion-influence-postoperative-complications
#19
Aye Sandar Zaw, Shashidhar B Kantharajanna, Karthikeyan Maharajan, Barry Tan, Amarasinghe A Saparamadu, Naresh Kumar
BACKGROUND: The question of independent association between allogeneic blood transfusion (ABT) and postoperative complications in cancer surgeries has been controversial and remains so. In metastatic spine tumor surgery (MSTS), previous studies investigated the influence of ABT on survival, but not on postoperative complications. We aimed to evaluate the influence of perioperative ABT on postoperative complications and infections in patients undergoing MSTS. STUDY DESIGN AND METHODS: This retrospective study included 247 patients who underwent MSTS at a single tertiary institution between 2005 and 2014...
September 16, 2017: Transfusion
https://www.readbyqxmd.com/read/28921037/-the-patient-blood-management-concept-joint-recommendation-of-the-german-society-of-anaesthesiology-and-intensive-care-medicine-and-the-german-society-of-surgery
#20
REVIEW
P Meybohm, T Schmitz-Rixen, A Steinbicker, W Schwenk, K Zacharowski
Patient blood management is a multimodal concept that aims to detect, prevent and treat anemia, optimize hemostasis, minimize iatrogenic blood loss, and support a patient-centered decision to provide optimal use of allogeneic blood products. Although the World Health Organization (WHO) has already recommended patient blood management as a new standard in 2010, many hospitals have not implemented it at all or only in part in clinical practice. The German Society of Anaesthesiology and Intensive Care Medicine and the German Society of Surgery therefore demand that i) all professionals involved in the treatment should implement important aspects of patient blood management considering local conditions, and ii) the structural, administrative and budgetary conditions should be created in the health care system to implement more intensively many of the measures in Germany...
October 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
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