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"Patient Blood Management"

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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
#1
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...
September 18, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28919087/outcomes-of-restrictive-versus-liberal-transfusion-strategies-in-older-adults-from-nine-randomised-controlled-trials-a-systematic-review-and-meta-analysis
#2
Geoff I Simon, Alison Craswell, Ogilvie Thom, Yoke Lin Fung
BACKGROUND: Guidelines for patient blood management recommend restrictive transfusion practice for most adult patients. These guidelines are supported by evidence from randomised controlled trials (RCTs); however, one of the patient groups not explicitly examined in these studies is the geriatric population. We examined RCTs relevant to transfusion outcomes in older patients. Our aim was to determine whether special guidelines are warranted for geriatric patients, recognising the different pathophysiological characteristics of this group...
September 11, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28885447/promoting-safety-quality-and-value-through-patient-blood-management
#3
Jonathan H Waters
No abstract text is available yet for this article.
September 7, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28885446/implementing-a-health-system-wide-patient-blood-management-program-with-a-clinical-community-approach
#4
Steven M Frank, Rajiv N Thakkar, Stanley J Podlasek, K H Ken Lee, Tyler L Wintermeyer, Will W Yang, Jing Liu, Leo C Rotello, Thomas A Fleury, Pat A Wachter, Lisa E Ishii, Renee Demski, Peter J Pronovost, Paul M Ness
BACKGROUND: Patient blood management programs are gaining popularity as quality improvement and patient safety initiatives, but methods for implementing such programs across multihospital health systems are not well understood. Having recently incorporated a patient blood management program across our health system using a clinical community approach, we describe our methods and results. METHODS: We formed the Johns Hopkins Health System blood management clinical community to reduce transfusion overuse across five hospitals...
September 7, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28869718/prevalence-and-causes-of-preoperative-anaemia-in-elective-major-surgery-patients
#5
Frank S Hong, Nicole Sieradzki, Claire Pollock, Faye Nasra, Allison Mo, Abbey Willcox, Leonid Churilov, Wai Khoon Ho, Carole Smith
BACKGROUND: Preoperative anaemia is associated with increased morbidity and mortality in surgical patients. Recent national patient blood management guideline recommended screening surgical patients for anaemia and in particular iron deficiency anaemia, without reference to the prevalence of anaemia or iron deficiency anaemia in this patient population. AIMS: To establish the prevalence and cause of preoperative anaemia in elective major surgery patients. METHODS: Patients attending the anaesthetic pre-admission clinics from 1 July 2013 to 30 June 2014 prior to their major elective surgery in our institution were screened for anaemia and iron deficiency by measuring full blood count, iron studies and C-reactive protein...
September 4, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28811051/patient-blood-management-in-the-intensive-care-unit
#6
REVIEW
Aryeh Shander, Mazyar Javidroozi, Gregg Lobel
Patient Blood Management underscores a fundamental shift from a product-centered approach to a patient-centric approach through timely application of evidence-based medical and surgical concepts designed to maintain hemoglobin concentration, optimize hemostasis, and minimize blood loss in an effort to improve patient outcome. In this concept, allogeneic blood transfusion is not viewed as the treatment of default for anemic patients, but one among many treatment modalities that should be weighed based on its merits-potentials risks and benefits-for the individual patient in the context of other alternatives...
July 31, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28776639/postpartum-obstetric-red-cell-transfusion-practice-a-retrospective-study-in-a-tertiary-obstetric-centre
#7
Benjamin Stephens, Farah Sethna, Philip Crispin
BACKGROUND: Traditional management of anaemia due to postpartum haemorrhage (PPH) has relied upon salvage therapy with red cell transfusion. Recently published guidance recommends a change in approach toward holistic patient blood management. AIMS: To determine whether postpartum red cell transfusion practices are consistent with best practice and to identify opportunities for improvement. MATERIALS AND METHODS: A retrospective audit of postpartum red cell transfusions was conducted at a tertiary level obstetrics unit...
August 4, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28738983/power-knowledge-and-transfusions-the-need-to-refocus-on-patient-blood-management
#8
EDITORIAL
Aryeh Shander, Sherri Ozawa, Gregg Lobel
No abstract text is available yet for this article.
August 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28722245/patient-blood-management-in-obstetrics-management-of-anaemia-and-haematinic-deficiencies-in-pregnancy-and-in-the-post-partum-period-nata-consensus-statement
#9
M Muñoz, J P Peña-Rosas, S Robinson, N Milman, W Holzgreve, C Breymann, F Goffinet, J Nizard, F Christory, C-M Samama, J-F Hardy
No abstract text is available yet for this article.
July 19, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/28719425/organizational-contributors-to-the-variation-in-red-blood-cell-transfusion-practices-in-cardiac-surgery-survey-results-from-the-state-of-michigan
#10
Anton Camaj, Darin B Zahuranec, Gaetano Paone, Barbara R Benedetti, Warren D Behr, Marc A Zimmerman, Min Zhang, Robert S Kramer, Jason Penn, Patricia F Theurer, Theron A Paugh, Milo Engoren, Alphonse DeLucia, Richard L Prager, Donald S Likosky
BACKGROUND: While large volumes of red blood cell transfusions are given to preserve life for cardiac surgical patients, indications for lower volume transfusions (1-2 units) are less well understood. We evaluated the relationship between center-level organizational blood management practices and center-level variability in low volume transfusion rates. METHODS: All 33 nonfederal, Michigan cardiac surgical programs were surveyed about their blood management practices for isolated, nonemergent coronary bypass procedures, including: (1) presence and structure of a patient blood management program, (2) policies and procedures, and (3) audit and feedback practices...
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28673310/the-evaluation-of-enhanced-feedback-interventions-to-reduce-unnecessary-blood-transfusions-affinitie-protocol-for-two-linked-cluster-randomised-factorial-controlled-trials
#11
Suzanne Hartley, Robbie Foy, Rebecca E A Walwyn, Robert Cicero, Amanda J Farrin, Jill J Francis, Fabiana Lorencatto, Natalie J Gould, John Grant-Casey, Jeremy M Grimshaw, Liz Glidewell, Susan Michie, Stephen Morris, Simon J Stanworth
BACKGROUND: Blood for transfusion is a frequently used clinical intervention, and is also a costly and limited resource with risks. Many transfusions are given to stable and non-bleeding patients despite no clear evidence of benefit from clinical studies. Audit and feedback (A&F) is widely used to improve the quality of healthcare, including appropriate use of blood. However, its effects are often inconsistent, indicating the need for coordinated research including more head-to-head trials comparing different ways of delivering feedback...
July 3, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28671296/blood-use-in-patients-receiving-intensive-chemotherapy-for-acute-leukemia-or-hematopoietic-stem-cell-transplantation-the-impact-of-a-health-system-wide-patient-blood-management-program
#12
Michael F Leahy, Kevin M Trentino, Colleen May, Stuart G Swain, Hun Chuah, Shannon L Farmer
BACKGROUND: Little is published on patient blood management (PBM) programs in hematology. In 2008 Western Australia announced a health system-wide PBM program with PBM staff appointments commencing in November 2009. Our aim was to assess the impact this program had on blood utilization and patient outcomes in intensive chemotherapy for acute leukemia or hematopoietic stem cell transplantation. STUDY DESIGN AND METHODS: A retrospective study of 695 admissions at two tertiary hospitals receiving intensive chemotherapy for acute leukemia or undergoing hematopoietic stem cell transplantation between July 2010 and December 2014 was conducted...
September 2017: Transfusion
https://www.readbyqxmd.com/read/28655949/peri-operative-blood-management
#13
REVIEW
Alex Eeles, Ravishankar Rao Baikady
Anaemia and allogeneic blood transfusions in surgical patients are associated with poor outcomes. Patient blood management (PBM) has been developed as an evidence-based clinical tool, by which clinicians can optimise anaemia, manage peri-operative bleeding, avoid unnecessary blood transfusion and improve patient outcome. This article aims to highlight the recent updates regarding evidence-based PBM in the perioperative period, following a thorough literature review involving original research articles, published guidelines and consensus documents discovered through an extensive PubMed and Medline search...
June 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28647104/-french-haemovigilance-from-1994-to-nowadays-evolution-and-prospects
#14
B Lassale, G Daurat, M Besse-Moreau, J-P Aullen
Born in France in 1993, haemovigilance aims at monitoring the blood transfusion chain from the donor to the recipient, receiving labile blood products. It differs from the other vigilances due to its organization and its completeness dealing with the collected information. Prior to the European directive, the French agency created a new gravity level: grade 0, aiming at reporting and analyzing the blood transfusion chain dysfunction. Thus, haemovigilance gradually integrates the management of the risks and is given new missions in hospitals and private hospitals...
June 21, 2017: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/28643386/risks-and-trends-of-red-blood-cell-transfusion-in-obstetric-patients-a-retrospective-study-of-45-213-deliveries-using-administrative-data
#15
Nadine Shehata, Michaël Chassé, Jo Ann Colas, Malia Murphy, Alan J Forster, Ann K Malinowski, Robin Ducharme, Dean A Fergusson, Alan Tinmouth, Kumanan Wilson
BACKGROUND: Transfusion data for obstetric patients are scarce. Identifying characteristics associated with red blood cell transfusion (RBCT) is of importance to better identify patients who would benefit from blood conservation strategies as the risk of alloimmunization from RBCT has the potential to affect the fetus and newborn. STUDY DESIGN AND METHODS: We conducted a retrospective cohort study using hospital administrative data to identify trends and risk factors of RBCT in obstetric patients...
September 2017: Transfusion
https://www.readbyqxmd.com/read/28611958/management-of-blood-loss-in-hip-arthroplasty-korean-hip-society-current-consensus
#16
REVIEW
Joo-Hyoun Song, Jang Won Park, Young-Kyun Lee, In-Sung Kim, Jae-Hwi Nho, Kyung-Jae Lee, Kwan Kyu Park, Yeesuk Kim, Jai Hyung Park, Seung Beom Han
The volume of hip arthroplasty is stiffly increasing because of excellent clinical outcomes, however it has not been shown to decrease the incidence of transfusions due to bleeding related to this surgery. This is an important consideration since there are concerns about the side effects and social costs of transfusions. First, anemia should be assessed at least 30 days before elective hip arthroplasty, and if the subject is diagnosed as having anemia, an additional examination of the cause of the anemia should be carried and steps taken to address the anemia...
June 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/28594141/patient-blood-management-the-new-standard
#17
EDITORIAL
Donat R Spahn
No abstract text is available yet for this article.
June 2017: Transfusion
https://www.readbyqxmd.com/read/28580663/autologous-blood-salvage-in-the-era-of-patient-blood-management
#18
REVIEW
R A Sikorski, N A Rizkalla, W W Yang, S M Frank
Almost 150 years after the first autologous blood transfusion was reported, intraoperative blood salvage has become an important method of blood conservation. The primary goal of autologous transfusion is to reduce or avoid allogeneic red blood cell transfusion and the associated risks and costs. Autologous salvaged blood does not result in immunological challenge and its consequences, provides a higher quality red blood cell that has not been subjected to the adverse effects of blood storage, and can be more cost-effective than allogeneic blood when used for carefully selected surgical patients...
June 5, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28561148/-preoperative-preparation-patient-blood-management-what-is-optimal
#19
Patrick Meybohm, Markus M Müller, Kai Zacharowski
Patient Blood Management (PBM) focusses on anemia management, the minimization of (unnecessary) iatrogenic blood loss and the exhaustion of natural tolerance to anemia with rational use of red blood cell transfusion. The focus of the current review article is now the preoperative phase with the following PBM components: management of anemia, pre-transfusion analytics and management of anticoagulants. Preoperative anemia is an independent risk factor for increased perioperative morbidity and mortality. In elective surgery, the causes of anemia should be diagnosed prior to surgery as early as possible, and if indicated, a specific treatment for treatable causes should be initiated...
May 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28514321/patient-blood-management-in-major-orthopedic-surgery-less-erythropoietin-and-more-iron
#20
Emmanuel Rineau, Alexandra Stoyanov, Emmanuel Samson, Laurent Hubert, Sigismond Lasocki
Erythropoietin (EPO) is proposed preoperatively to reduce blood transfusion in anemic patients (hemoglobin < 13 g/dL) scheduled for a major orthopedic surgery. New intravenous iron formulations allow infusion of higher doses, increasing EPO response. In that context, we evaluated in a before-after study (n = 62 and 65 patients for each period) a new EPO administration protocol (2 injections 4 and 3 weeks before surgery, and a third if hemoglobin <13 g/dL instead of <15 g/dL 2 weeks before surgery)...
May 12, 2017: Anesthesia and Analgesia
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