South African National Blood Service, Johannesburg, South Africa.
S Afr Med J. 2019 Jun 28;109(7):471-476. doi: 10.7196/SAMJ.2019.v109i7.13859.
For more than 70 years the default therapy for anaemia and blood loss was mostly transfusion. Accumulating evidence demonstrates a significant dose-dependent relationship between transfusion and adverse outcomes. This and other transfusion-related challenges led the way to a new paradigm. Patient blood management (PBM) is the application of evidence-based practices to optimise patient outcomes by managing and preserving the patient's own blood. 'Real-world' studies have shown that PBM improves patient outcomes and saves money. The prevalence of anaemia in adult South Africans is 31% in females and 17% in males. Improving the management of anaemia will firstly improve public health, secondly relieve the pressure on the blood supply, and thirdly improve the productivity of the nation's workforce. While high-income countries are increasingly implementing PBM, many middle- and low-income countries are still trying to upscale their transfusion services. The implementation of PBM will improve South Africa's health status while saving costs.
70 多年来,贫血和失血的默认治疗方法主要是输血。越来越多的证据表明,输血与不良结果之间存在显著的剂量依赖性关系。这一现象以及其他与输血相关的挑战为一种新的模式铺平了道路。患者血液管理(PBM)是应用循证实践,通过管理和保存患者自身血液来优化患者结局。“真实世界”研究表明,PBM 可改善患者结局并节省资金。成年南非人贫血的患病率为女性 31%,男性 17%。改善贫血的管理将首先改善公共卫生,其次缓解血液供应的压力,第三提高国家劳动力的生产力。虽然高收入国家越来越多地实施 PBM,但许多中低收入国家仍在努力扩大其输血服务。实施 PBM 将改善南非的健康状况并节省成本。