Pell Lindsay J, Martin B Shane, Shirk Mary Beth
Department of Pharmacy, The Ohio State University Medical Center, Columbus, OH 43210, USA.
Am J Health Syst Pharm. 2005 Feb 15;62(4):400-5. doi: 10.1093/ajhp/62.4.0400.
An evidence-based epoetin alfa protocol and a multidisciplinary blood-conservation program were implemented in a medical intensive care unit (MICU) and surgical intensive care unit (SICU).
Baseline data were collected to evaluate the use of epoetin alfa and red blood cell (RBC) transfusions in our MICU and SICU. An evidence-based protocol for epoetin alfa use and a multidisciplinary blood-conservation program were designed, approved, and implemented. Preprotocol patients consisted of a convenience sample of 18 patients receiving epoetin alfa for various indications who were admitted to our MICU and SICU from January 1 to December 31, 2002. The postprotocol sample consisted of 40 patients who received epoetin alfa for the treatment of anemia due to critical illness who were admitted to the MICU and SICU from March 25 to May 23, 2003. Postprotocol data were collected and compared with baseline data. All patients seen in the MICU and SICU, during the postprotocol period, regardless of whether they were receiving epoetin alfa, were included in the multidisciplinary blood-conservation program. Postprotocol data showed statistically significant improvements in epoetin alfa dosing and monitoring and in the use of adjunctive therapy. Pharmacist-initiated blood-conservation strategies resulted in several blood-draw reductions and discontinuations. Statistically significant reductions in the number of RBC units transfused per patient and per intensive care unit (ICU) day were also observed.
An epoetin alfa protocol and a multidisciplinary blood-conservation program contributed to rational prescribing of epoetin alfa and to a reduction in the number of RBC units transfused per patient and per ICU day.
在医学重症监护病房（MICU）和外科重症监护病房（SICU）实施了基于循证的促红细胞生成素α方案和多学科血液保护计划。
收集基线数据以评估促红细胞生成素α和红细胞（RBC）输注在我们的MICU和SICU中的使用情况。设计、批准并实施了基于循证的促红细胞生成素α使用方案和多学科血液保护计划。方案实施前的患者包括2002年1月1日至12月31日期间入住我们MICU和SICU的18例因各种适应症接受促红细胞生成素α治疗的便利样本患者。方案实施后的样本包括2003年3月25日至5月23日期间入住MICU和SICU的40例因危重病导致贫血而接受促红细胞生成素α治疗的患者。收集方案实施后的数据并与基线数据进行比较。在方案实施期间，MICU和SICU中所有就诊的患者，无论是否接受促红细胞生成素α治疗，均纳入多学科血液保护计划。方案实施后的数据显示，促红细胞生成素α的给药和监测以及辅助治疗的使用有统计学上的显著改善。药剂师发起的血液保护策略减少了多次采血并停止了一些采血。还观察到每位患者和每个重症监护病房（ICU）日输注的RBC单位数量有统计学上显著减少。
促红细胞生成素α方案和多学科血液保护计划有助于促红细胞生成素α的合理处方，并减少每位患者和每个ICU日输注的RBC单位数量。
