Meybohm Patrick, Froessler Bernd, Goodnough Lawrence T, Klein Andrew A, Muñoz Manuel, Murphy Michael F, Richards Toby, Shander Aryeh, Spahn Donat R, Zacharowski Kai
Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.
Department of Anaesthesia, Lyell McEwin Hospital, South Australia, Australia.
Perioper Med (Lond). 2017 Mar 17;6:5. doi: 10.1186/s13741-017-0061-8. eCollection 2017.
More than 30% of the world's population are anemic with serious medical and economic consequences. Red blood cell transfusion is the mainstay to correct anemia, but it is also one of the top five overused procedures and carries its own risk and cost burden. Patient blood management (PBM) is a patient-centered and multidisciplinary approach to manage anemia, minimize iatrogenic blood loss, and harness tolerance to anemia in an effort to improve patient outcome. Despite resolution 63.12 of the World Health Organization in 2010 endorsing PBM and current guidelines which include evidence-based recommendations on the use of diagnostic/therapeutic resources to provide better health care, many hospitals have yet to implement PBM in routine clinical practice.
A number of experienced clinicians developed the following "Simplified International Recommendations for Patient Blood Management." We propose a series of simple, cost-effective, best-practice, feasible, and evidence-based measures that will enable any hospital to reduce both anemia prevalence on the day of intervention/surgery and anemia-related unnecessary transfusion in surgical and medical patients, including obstetrics and gynecology.
全球超过30%的人口患有贫血症,这会带来严重的医学和经济后果。红细胞输血是纠正贫血的主要手段,但它也是五大过度使用的医疗程序之一,且自身存在风险和成本负担。患者血液管理(PBM)是以患者为中心的多学科方法,用于管理贫血、尽量减少医源性失血,并利用对贫血的耐受性来改善患者预后。尽管世界卫生组织在2010年通过第63.12号决议认可了患者血液管理,且当前指南包含了关于使用诊断/治疗资源以提供更好医疗保健的循证建议,但许多医院尚未在日常临床实践中实施患者血液管理。
一些经验丰富的临床医生制定了以下“患者血液管理简化国际建议”。我们提出了一系列简单、具有成本效益、最佳实践、可行且基于证据的措施,这些措施将使任何医院都能降低干预/手术当天的贫血患病率,并减少手术和内科患者(包括妇产科患者)中与贫血相关的不必要输血。