Zacharowski Kai, Spahn Donat R
Department of Anesthesiology, Intensive Care Medicine & Pain Therapy, University Hospital Frankfurt, Germany.
Institute of Anesthesiology, University and University Hospital of Zurich, Zurich, Switzerland.
Best Pract Res Clin Anaesthesiol. 2016 Jun;30(2):159-69. doi: 10.1016/j.bpa.2016.04.008. Epub 2016 May 6.
Patient blood management (PBM) can be defined in many ways and may consist of hundreds of single measures to improve patient safety. Traditionally, PBM is based on three pillars and defined as (i) optimization of the endogenous red blood cell (RBC) mass through the targeted stimulation of erythropoiesis and the treatment of modifiable underlying disorders; (ii) minimization of diagnostic, interventional, and surgical blood loss to preserve the patient's RBC mass; and (iii) optimization of the patient-specific tolerance to anemia through strict adherence to physiological transfusion thresholds [1-4]. However, for this review, we have chosen the following three peri-interventional parts: (1) diagnosis and therapy of anemia, (2) optimal hemotherapy, and (3) minimization of hospital-acquired anemia. PBM is an evidence-based, multidisciplinary preventive, and therapeutic approach focusing each patient. The PBM concept involves the use of safe and effective medical and surgical methods and techniques designed to prevent peri-interventional anemia, rationalize use of blood products, and set good blood management measures in an effort to improve patient safety and outcome.
患者血液管理（PBM）可以从多种角度进行定义，可能包含数百项旨在提高患者安全性的单一措施。传统上，PBM基于三大支柱，并被定义为：（i）通过有针对性地刺激红细胞生成以及治疗可改变的潜在疾病来优化内源性红细胞（RBC）量；（ii）将诊断、介入和手术过程中的失血降至最低，以维持患者的RBC量；（iii）通过严格遵守生理输血阈值来优化患者对贫血的特异性耐受性[1-4]。然而，在本综述中，我们选择了以下三个围手术期部分：（1）贫血的诊断与治疗，（2）优化血液治疗，以及（3）将医院获得性贫血降至最低。PBM是一种基于证据的、多学科的针对每位患者的预防和治疗方法。PBM概念涉及使用安全有效的医学和外科方法及技术，旨在预防围手术期贫血、合理使用血液制品，并制定良好的血液管理措施，以努力提高患者安全性和治疗效果。
