Duarte Gustavo de Carvalho, Neto Francisco Guilherme Fujita, Júnior José Francisco Comenalli Marques, Langhi Dante Mario
H. Hemo Hemoterapia Brasil SA, São Paulo, SP, Brazil; Fujisan, Fortaleza, CE, Brazil.
H. Hemo Hemoterapia Brasil SA, São Paulo, SP, Brazil; Fujisan, Fortaleza, CE, Brazil.
Hematol Transfus Cell Ther. 2022 Jul-Sep;44(3):374-378. doi: 10.1016/j.htct.2020.12.010. Epub 2021 Mar 14.
Patient blood management (PBM) programs are associated with better patient outcomes, a reduced number of transfusions and cost-savings The Clinical Decision Support (CDS) systems are valuable tools in this process, but their availability is limited in developing countries This study assesses the feasibility and effectiveness of an adapted CDS system for low-income countries.
This was a prospective study of the PBM program implementation, in a 200-bed tertiary hospital, between February 2019 and May 2020. Outcome measures were red blood cell (RBC), fresh frozen plasma (FFP) and platelet unit transfusions, the transfusion of a single unit of red blood cells and an RBC adequacy index (RAI).
Comparing the post-PBM program era with the pre-PBM system era, there was a decrease in red blood cell transfusions (p=0.05), with an increase in single unit red blood cell transfusions (p=0.005) and RAI (p<0.001).
The PBM programs, including electronic transfusion guidelines with pre-transfusion medical auditing, was associated with improved transfusion practices and reduced product acquisition-related costs.
患者血液管理（PBM）项目与更好的患者预后、减少输血次数和节省成本相关。临床决策支持（CDS）系统是这一过程中的宝贵工具，但在发展中国家其可用性有限。本研究评估了一种适用于低收入国家的CDS系统的可行性和有效性。
这是一项对2019年2月至2020年5月期间在一家拥有200张床位的三级医院实施的PBM项目的前瞻性研究。结果指标包括红细胞（RBC）、新鲜冰冻血浆（FFP）和血小板单位输注量、单次红细胞单位输注量以及红细胞充足指数（RAI）。
将PBM项目实施后时期与PBM系统实施前时期进行比较，红细胞输注量减少（p=0.05），单次红细胞单位输注量增加（p=0.005），红细胞充足指数增加（p<0.001）。
包括带有输血前医学审核的电子输血指南在内的PBM项目与改善输血实践以及降低与产品采购相关的成本相关。
