From the Department of Anesthesiology, Critical Care and Hyperbaric Medicine, Englewood Health, Englewood, New Jersey.
Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
Anesth Analg. 2020 Jul;131(1):74-85. doi: 10.1213/ANE.0000000000004844.
The World Health Organization (WHO) has declared coronavirus disease 2019 (COVID-19), the disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a pandemic. Global health care now faces unprecedented challenges with widespread and rapid human-to-human transmission of SARS-CoV-2 and high morbidity and mortality with COVID-19 worldwide. Across the world, medical care is hampered by a critical shortage of not only hand sanitizers, personal protective equipment, ventilators, and hospital beds, but also impediments to the blood supply. Blood donation centers in many areas around the globe have mostly closed. Donors, practicing social distancing, some either with illness or undergoing self-quarantine, are quickly diminishing. Drastic public health initiatives have focused on containment and "flattening the curve" while invaluable resources are being depleted. In some countries, the point has been reached at which the demand for such resources, including donor blood, outstrips the supply. Questions as to the safety of blood persist. Although it does not appear very likely that the virus can be transmitted through allogeneic blood transfusion, this still remains to be fully determined. As options dwindle, we must enact regional and national shortage plans worldwide and more vitally disseminate the knowledge of and immediately implement patient blood management (PBM). PBM is an evidence-based bundle of care to optimize medical and surgical patient outcomes by clinically managing and preserving a patient's own blood. This multinational and diverse group of authors issue this "Call to Action" underscoring "The Essential Role of Patient Blood Management in the Management of Pandemics" and urging all stakeholders and providers to implement the practical and commonsense principles of PBM and its multiprofessional and multimodality approaches.
世界卫生组织(WHO)已宣布由严重急性呼吸系统综合症冠状病毒 2 型(SARS-CoV-2)引起的 2019 年冠状病毒病(COVID-19)为大流行。由于 SARS-CoV-2 广泛而迅速地在人与人之间传播,并且 COVID-19 在全球范围内具有高发病率和死亡率,因此全球医疗保健现在面临着前所未有的挑战。在世界各地,医疗保健受到严重短缺的困扰,不仅缺乏洗手液、个人防护设备、呼吸机和病床,而且还阻碍了血液供应。全球许多地区的献血中心大多关闭。由于社交隔离,一些献血者要么生病,要么自我隔离,献血者迅速减少。严格的公共卫生措施侧重于遏制和“拉平曲线”,同时宝贵的资源正在枯竭。在一些国家,对包括供体血液在内的此类资源的需求已经超过了供应。关于血液安全性的问题仍然存在。尽管通过异体输血传播病毒的可能性似乎不大,但这仍有待充分确定。随着选择的减少,我们必须在全球范围内制定区域和国家短缺计划,并更重要的是传播和立即实施患者血液管理(PBM)知识。PBM 是一种基于证据的护理措施,通过临床管理和保存患者自身血液来优化医疗和手术患者的结果。这组来自多个国家和地区的作者发出了这一“行动呼吁”,强调“患者血液管理在大流行管理中的重要作用”,并敦促所有利益攸关方和提供者实施 PBM 的实用和常识性原则及其多专业和多模式方法。