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"Blood management"

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https://www.readbyqxmd.com/read/28220499/three-year-follow-up-of-implementation-of-evidence-based-transfusion-practice-in-a-tertiary-hospital
#1
A Norgaard, J Stensballe, T H de Lichtenberg, J O White, A Perner, M Wanscher, J Hillingsø, M L Holm, M Mau-Sørensen, H Sillesen, L Kjeldsen, C Bäck, J Nielsen, J Seeberg, M B Hansen, P I Johansson
BACKGROUND AND OBJECTIVES: Traditionally, Denmark has had a high rate of allogeneic red blood cell transfusion caused by a liberal transfusion practice despite the existence of restrictive guidelines. We established a Patient Blood Management programme in a tertiary hospital and report the results of the implementation of evidence-based transfusion practice. MATERIALS AND METHODS: Red blood cell transfusion quality indicators were compared with the evidence-based guideline at hospital and department level...
February 20, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28194656/all-blood-counts-a-manual-for-blood-conservation-and-patient-blood-management-thomas-dafydd-john-thompson-biddy-ridler-editors-tfm-publishing-limited-castle-hill-barns-nr-shrewbury-sy5-6lx-2016-59-95-usd-80-cdn-530-pages-isbn-978-1-903378-95-3
#2
https://www.readbyqxmd.com/read/28165794/patient-blood-management-an-update-of-current-guidance-in-clinical-practice
#3
Jayne Peters, Kate Pendry
Patient blood management is a global, evidence-based, multidisciplinary initiative to reduce unnecessary blood transfusion while optimizing other available techniques. This article summarizes current patient blood management strategies and highlights future developments in UK practice.
February 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28164305/single-unit-transfusions-and-hemoglobin-trigger-relative-impact-on-red-cell-utilization
#4
William W Yang, Rajiv N Thakkar, Eric A Gehrie, Weiyun Chen, Steven M Frank
BACKGROUND: Patient blood management (PBM) programs can reduce unnecessary transfusions, but the optimal methods used to achieve this effect are unclear. We tested the hypothesis that encouraging single-unit red blood cell (RBC) transfusions in stable patients would have a greater impact on blood use than compliance with a specific hemoglobin (Hb) transfusion trigger alone. STUDY DESIGN AND METHODS: We analyzed blood utilization data at three community hospitals without previous PBM efforts before and after implementing a PBM program...
February 5, 2017: Transfusion
https://www.readbyqxmd.com/read/28151388/peri-operative-treatment-of-anaemia-in-major-orthopaedic-surgery-a-practical-approach-from-spain
#5
REVIEW
Elvira Bisbe, Misericordia Basora, María J Colomina
In patients undergoing major orthopaedic surgery, pre-operative anaemia, peri-operative bleeding and a liberal transfusion policy are the main risk factors for requiring red blood cell transfusion (RBCT). The clinical and economic disadvantages of RBCT have led to the development and implementation of multidisciplinary, multimodal, individualised strategies, collectively termed patient blood management, which aim to reduce RBCT and improve patients' clinical outcome and safety. Within a patient blood management programme, low pre-operative haemoglobin is one of the few modifiable risk factors for RBCT...
January 26, 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/28150313/improved-outcomes-and-reduced-costs-associated-with-a-health-system-wide-patient-blood-management-program-a-retrospective-observational-study-in-four-major-adult-tertiary-care-hospitals
#6
Michael F Leahy, Axel Hofmann, Simon Towler, Kevin M Trentino, Sally A Burrows, Stuart G Swain, Jeffrey Hamdorf, Trudi Gallagher, Audrey Koay, Gary C Geelhoed, Shannon L Farmer
BACKGROUND: Patient blood management (PBM) programs are associated with improved patient outcomes, reduced transfusions and costs. In 2008, the Western Australia Department of Health initiated a comprehensive health-system-wide PBM program. This study assesses program outcomes. STUDY DESIGN AND METHODS: This was a retrospective study of 605,046 patients admitted to four major adult tertiary-care hospitals between July 2008 and June 2014. Outcome measures were red blood cell (RBC), fresh-frozen plasma (FFP), and platelet units transfused; single-unit RBC transfusions; pretransfusion hemoglobin levels; elective surgery patients anemic at admission; product and activity-based costs of transfusion; in-hospital mortality; length of stay; 28-day all-cause emergency readmissions; and hospital-acquired complications...
February 2, 2017: Transfusion
https://www.readbyqxmd.com/read/28107785/blood-management-strategies-to-reduce-transfusions-after-elective-lower-extremity-joint-arthroplasty-surgeries
#7
Ankit Kansagra, Chester Andrzejewski, Robert Krushell, Andrew Lehman, Jordan Greenbaum, Paul Visintainer, Joan McGirr, Kathleen Mahoney, Darlene Cloutier, Alice Ehresman, Mihaela S Stefan
Blood loss associated with lower-extremity total joint arthroplasty (TJA) often results in anemia and the need for red blood cell transfusions (RBCTs). This article reports on a quality improvement initiative aimed at improving blood management strategies in patients undergoing TJA. A multifaceted intervention (preoperative anemia assessment, use of tranexamic acid, discouragement of autologous preoperative blood collection, restrictive RBCT protocols) was implemented. The results were stratified into 3 intervention periods: 1, pre; 2, peri; and 3, post...
January 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28104403/a-model-to-predict-risk-of-blood-transfusion-after-gynecologic-surgery
#8
Jamie Stanhiser, Kevin Chagin, J Eric Jelovsek
BACKGROUND: A model that predicts a patient's risk of receiving a blood transfusion may facilitate selective preoperative testing and more efficient perioperative blood management utilization. OBJECTIVE: We sought to construct and validate a model that predicts a patient's risk of receiving a blood transfusion after gynecologic surgery. STUDY DESIGN: In all, 18,319 women who underwent gynecologic surgery at 10 institutions in a single health system by 116 surgeons from January 2010 through June 2014 were analyzed...
January 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28092401/randomized-clinical-trial-of-preoperative-oral-versus-intravenous-iron-in-anaemic-patients-with-colorectal-cancer
#9
B D Keeler, J A Simpson, O Ng, H Padmanabhan, M J Brookes, A G Acheson
BACKGROUND: Treatment of preoperative anaemia is recommended as part of patient blood management, aiming to minimize perioperative allogeneic red blood cell transfusion. No clear evidence exists outlining which treatment modality should be used in patients with colorectal cancer. The study aimed to compare the efficacy of preoperative intravenous and oral iron in reducing blood transfusion use in anaemic patients undergoing elective colorectal cancer surgery. METHODS: Anaemic patients with non-metastatic colorectal adenocarcinoma were recruited at least 2 weeks before surgery and randomized to receive oral (ferrous sulphate) or intravenous (ferric carboxymaltose) iron...
February 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28072934/aetiology-of-preoperative-anaemia-in-patients-undergoing-elective-cardiac-surgery-the-challenge-of-pillar-one-of-patient-blood-management
#10
J Abraham, R Sinha, K Robinson, V Scotland, D Cardone
Preoperative anaemia is common in patients undergoing cardiac surgery. Whilst there is a strong association with increased morbidity and mortality, it is currently unclear whether treatment of anaemia leads to patient benefit. This retrospective study aimed to determine the aetiology of preoperative anaemia in a cohort of patients undergoing elective cardiac surgery over two years at a tertiary hospital. Laboratory data obtained at the preoperative assessment clinic visit were assessed to stratify patients into four groups-iron deficiency anaemia (IDA), possible IDA, anaemia of chronic disease (ACD) and non-anaemic patients with low ferritin according to the 'Preoperative haemoglobin assessment and optimisation template' of the Australian Patient Blood Management (PBM) Guidelines...
January 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28007726/patient-blood-management-a-role-for-pharmacists
#11
Aryeh Shander, Jeff Nemeth, Joseph E Cruz, Mazyar Javidroozi
No abstract text is available yet for this article.
January 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27987219/relative-efficacy-of-tranexamic-acid-and-preoperative-anemia-treatment-for-reducing-transfusions-in-total-joint-arthroplasty
#12
Joseph F Styron, Alison K Klika, Caleb R Szubski, Deborah Tolich, Wael K Barsoum, Carlos A Higuera
BACKGROUND: This study aimed to evaluate the efficacy of a perioperative blood management (PBM) protocol at a large, tertiary hospital at reducing blood transfusions after total hip or knee arthroplasty (THA or TKA). STUDY DESIGN AND METHODS: A retrospective review of the PBM for patients undergoing THA or TKA was performed. Adjusted multiple logistic and Poisson regression models examined the effect of patient characteristics and preoperative, intraoperative, and postoperative factors on the likelihood of transfusion and units transfused...
December 17, 2016: Transfusion
https://www.readbyqxmd.com/read/27984342/strategies-to-prevent-periprosthetic-joint-infection-after-total-knee-arthroplasty-and-lessen-the-risk-of-readmission-for-the-patient
#13
Richard Iorio, Feroz A Osmani
There is yet to be a standardized total knee arthroplasty (TKA) surgical protocol that has been studied to a sufficient degree to offer evidence-based practices regarding infection and readmission prevention. Although high-level evidence is often sought to provide guidance concerning protocol- and process-level decisions, the literature is often confusing and nondefinitive in its conclusions and recommendations regarding periprosthetic joint infection and readmission prevention. Areas of study that require further investigation include the following: the role of patient optimization and preoperative mitigation of risk; perioperative antibiotics; operating room environment; blood management; operative techniques, implants, and infection prevention measures; wound care management; and post acute care...
February 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27977460/perioperative-outcomes-and-management-in-pediatric-complex-cranial-vault-reconstruction-a-multicenter-study-from-the-pediatric-craniofacial-collaborative-group
#14
Paul A Stricker, Susan M Goobie, Franklyn P Cladis, Charles M Haberkern, Petra M Meier, Srijaya K Reddy, Thanh T Nguyen, Lingyu Cai, Marcia Polansky, Peter Szmuk, John Fiadjoe, Codruta Soneru, Ricardo Falcon, Timothy Petersen, Courtney Kowalczyk-Derderian, Nicholas Dalesio, Stefan Budac, Neels Groenewald, Daniel Rubens, Douglas Thompson, Rheana Watts, Katherine Gentry, Iskra Ivanova, Mali Hetmaniuk, Vincent Hsieh, Michael Collins, Karen Wong, Wendy Binstock, Russell Reid, Kim Poteet-Schwartz, Heike Gries, Rebecca Hall, Jeffrey Koh, Carolyn Bannister, Wai Sung, Ranu Jain, Allison Fernandez, Gerald F Tuite, Ernesto Ruas, Oleg Drozhinin, Lisa Tetreault, Bridget Muldowney, Karene Ricketts, Patrick Fernandez, Lisa Sohn, John Hajduk, Brad Taicher, Jessica Burkhart, Allison Wright, Jane Kugler, Lea Barajas-DeLoa, Meera Gangadharan, Veronica Busso, Kayla Stallworth, Susan Staudt, Kristen L Labovsky, Chris D Glover, Henry Huang, Helena Karlberg-Hippard, Samantha Capehart, Cynthia Streckfus, Kim-Phuong T Nguyen, Peter Manyang, Jose Luis Martinez, Jennifer K Hansen, Heather Mitzel Levy, Alyssa Brzenski, Franklin Chiao, Pablo Ingelmo, Razaz Mujallid, Olutoyin A Olutoye, Tariq Syed, Hubert Benzon, Adrian Bosenberg
BACKGROUND: The Pediatric Craniofacial Collaborative Group established the Pediatric Craniofacial Surgery Perioperative Registry to elucidate practices and outcomes in children with craniosynostosis undergoing complex cranial vault reconstruction and inform quality improvement efforts. The aim of this study is to determine perioperative management, outcomes, and complications in children undergoing complex cranial vault reconstruction across North America and to delineate salient features of current practices...
February 2017: Anesthesiology
https://www.readbyqxmd.com/read/27914900/re-the-important-role-for-intravenous-iron-in-perioperative-patient-blood-management-in-major-abdominal-surgery-a-randomized-controlled-trial
#15
Matthew J Young, Aidan P Noon
No abstract text is available yet for this article.
November 30, 2016: European Urology
https://www.readbyqxmd.com/read/27913130/topical-tranexamic-acid-is-equivalent-to-targeted-preoperative-autologous-blood-donation-in-total-hip-arthroplasty
#16
Maximilian F Kasparek, Martin Faschingbauer, Wenzel Waldstein, Cosima S Boettner, Friedrich Boettner
BACKGROUND: Topical tranexamic acid (TXA) was introduced to replace the previous targeted preoperative autologous blood donation (PABD) program. This study aims to analyze the efficacy of topical TXA compared with targeted PABD in anemic patients undergoing primary total hip arthroplasty (THA). METHODS: Two thousand two hundred fifty-one patients underwent primary THA between 2009 and 2013 using targeted autologous blood donation for 280 anemic patients (12%; Hb <12...
October 31, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27902502/zika-virus-and-patient-blood-management
#17
Lawrence T Goodnough, Marisa B Marques
Sporadic Zika virus infections had only occurred in Africa and Asia until an outbreak in Micronesia (Oceania) in 2007. In 2013 to 2014, several outer Pacific Islands reported local outbreaks. Soon thereafter, the virus was likely introduced in Brazil from competing athletes from French Polynesia and other countries that participated in a competition there. Transmission is thought to have occurred through mosquito bites and spread to the immunologically naive population. Being also a flavivirus, the Zika virus is transmitted by the Aedes mosquito that is endemic in South and Central America that is also the vector of West Nile virus, dengue, and chikungunya...
January 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27898431/improving-outcome-of-trauma-patients-by-implementing-patient-blood-management
#18
Christoph Füllenbach, Kai Zacharowski, Patrick Meybohm
PURPOSE OF REVIEW: Patient blood management aims to improve patient outcome and safety by reducing the number of unnecessary red blood cell transfusions and vitalizing patient-specific anemia reserves. While this is increasingly recognized as best clinical practice in elective surgery, the implementation in the setting of trauma is restrained because of typically nonelective (emergency) surgery and, in specific circumstances, allogeneic blood transfusions as life-saving therapy. RECENT FINDINGS: Viscoelastic diagnostics allow a precise identification of trauma-induced coagulopathy...
November 24, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27878812/perioperative-blood-transfusion-does-it-influence-survival-and-cancer-progression-in-metastatic-spine-tumor-surgery
#19
Aye Sandar Zaw, Shashidhar B Kantharajanna, Karthikeyan Maharajan, Barry Tan, Balamurugan Vellayappan, Naresh Kumar
BACKGROUND: Despite advances in surgical techniques for spinal metastases, there is often substantial blood loss, resulting in patients requiring blood transfusion during the perioperative period. Allogeneic blood transfusion (ABT) has been the main replenishment method for lost blood. However, the impact of ABT on cancer-related outcomes has been controversial in various studies. We aimed to evaluate the influence of perioperative ABT on disease progression and survival in patients undergoing metastatic spinal tumor surgery (MSTS)...
February 2017: Transfusion
https://www.readbyqxmd.com/read/27873340/adequacy-of-physician-documentation-and-correlation-with-assessment-of-transfusion-appropriateness-a-follow-up-study-in-the-setting-of-prospective-audits-and-patient-blood-management
#20
Emilio Madrigal, Shyam Prajapati, Vaidehi Avadhani, Kyle Annen, Mark T Friedman
BACKGROUND: A previous study in our hospitals correlated suboptimal documentation and failure to justify transfusions. In light of implemented blood-conservation strategies, including patient blood management (PBM) and prospective audits (PAs), we performed a follow-up study. STUDY DESIGN AND METHODS: We reviewed prospectively audited red blood cell (RBC) transfusions received by adult patients from January to July 2014. Survey forms were used to assess the level of documentation and to classify documentation as adequate, intermediate, or inadequate...
November 21, 2016: Transfusion
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