Kumar Naresh, Lee Eunice Xin Yi, Hui Si Jian, Kumar Laranya, Jonathan Tan Jiong Hao, Ashokka Balakrishnan
University Spine Centre, Department of Orthopaedic Surgery, National University Health System, Singapore.
Department of Anaesthesia, National University Hospital, Singapore.
Global Spine J. 2024 Mar 7:21925682231167096. doi: 10.1177/21925682231167096.
Narrative review.
The spine is the most common site of metastases, associated with decreased quality of life. Increase in metastatic spine tumour surgery (MSTS) has caused us to focus on the management of blood, as blood loss is a significant morbidity in these patients. However, blood transfusion is also not without its own risks, and hence this led to blood conservation strategies and implementation of a concept of patient blood management (PBM) in clinical practise focusing on these patients.
A narrative review was conducted and all studies that were related to blood management in metastatic spine disease as well as PBM surrounding this condition were included.
A total of 64 studies were included in this review. We discussed a new concept of patient blood management in patients undergoing MSTS, with stratification to pre-operative and intra-operative factors, as well as anaesthesia and surgical considerations. The studies show that PBM and reduction in blood transfusion allows for reduced readmission rates, lower risks associated with blood transfusion, and lower morbidity for patients undergoing MSTS.
Through this review, we highlight various pre-operative and intra-operative methods in the surgical and anaesthesia domains that can help with PBM. It is an important concept with the significant amount of blood loss expected from MSTS.
Not applicable.
叙述性综述。
脊柱是最常见的转移部位，与生活质量下降相关。转移性脊柱肿瘤手术（MSTS）的增加使我们将重点放在血液管理上，因为失血是这些患者的一项重大发病因素。然而，输血也并非没有自身风险，因此这促使在临床实践中针对这些患者制定血液保护策略并实施患者血液管理（PBM）概念。
进行了一项叙述性综述，纳入了所有与转移性脊柱疾病血液管理以及围绕该病症的PBM相关的研究。
本综述共纳入64项研究。我们讨论了接受MSTS患者的患者血液管理新概念，对术前和术中因素以及麻醉和手术考量进行了分层。研究表明，PBM和减少输血可降低再次入院率、降低与输血相关的风险，并降低接受MSTS患者的发病率。
通过本综述，我们强调了手术和麻醉领域中有助于PBM的各种术前和术中方法。鉴于MSTS预计会有大量失血，这是一个重要概念。
不适用。
