Babik Barna, Fazakas János, Matusovits Andrea, Gál János, Fülesdi Béla
Általános Orvostudományi Kar, Aneszteziológiai és Intenzív Terápiás Intézet,Szegedi Tudományegyetem, Szeged, Semmelweis u. 6., 6720.
Általános Orvostudományi Kar, Transzplantációs és Sebészeti Klinika,Semmelweis Egyetem, Budapest.
Orv Hetil. 2020 Sep;161(37):1545-1553. doi: 10.1556/650.2020.31918.
Human red blood cell concentrate and platelet suspension are unstable preparations, therefore, they are not part of the international pharmaceutical market for biological and economic reasons. Consequently, they cannot be replaced by external sources. Human allogeneic erythrocyte and platelet preparations should therefore be considered as part of the common national wealth. The amount of transfused red blood cell concentrate has been declining in countries with advanced health systems in recent years. The changes were initially driven by the spread of the concept and practice of liberal and restrictive transfusion triggers. A complex, thoughtful system of perioperative blood utilization, the Patient Blood Management has later emerged, and a paradigm shift in the delivery of life-threatening perioperative bleeding has developed. At the same time, clinical practitioners are facing a new challenge of reducing willingness to donate blood worldwide. The rationalization of the use of human red blood cell concentrate and platelet suspension is essential in Hungary. As a health care measure, the currently rigidly earmarked financial resources available for allogeneic preparations and stable factor concentrates for the treatment of life-threatening haemorrhages need to be changed to be interoperable. The perioperative blood use could additionally be reduced by the widespread dissemination of the Patient Blood Management requiring complex coordinated educational interdisciplinary and logistical work. Orv Hetil. 2020; 161(37): 1545-1553.
人红细胞浓缩物和血小板悬液是不稳定的制剂，因此，出于生物学和经济原因，它们不属于国际生物制药市场的一部分。因此，它们无法被外部来源所替代。人同种异体红细胞和血小板制剂因此应被视为国家共同财富的一部分。近年来，在医疗体系发达的国家，输注的红细胞浓缩物数量一直在下降。这些变化最初是由宽松和严格输血触发因素的概念和实践的传播所推动的。后来出现了一个复杂、周全的围手术期血液利用系统，即患者血液管理，并且在危及生命的围手术期出血处理方面发生了范式转变。与此同时，临床医生正面临着全球范围内献血意愿降低的新挑战。在匈牙利，合理使用人红细胞浓缩物和血小板悬液至关重要。作为一项医疗保健措施，目前专门用于同种异体制剂和治疗危及生命出血的稳定因子浓缩物的严格指定财务资源需要改变，以便具有通用性。通过广泛传播需要复杂协调的教育、跨学科和后勤工作的患者血液管理，围手术期的血液使用还可以进一步减少。《匈牙利医学周报》。2020年；161(37):1545 - 1553。
