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巴西血液学、血液治疗与细胞治疗协会关于患者血液管理的共识:全球及巴西患者血液管理的历史与现状

Consensus of the Brazilian association of hematology, hemotherapy and cellular therapy on patient blood management: History and scenario of patient blood management in the world and in Brazil.

作者信息

Montano-Pedroso Juan Carlos, Biagini Silvana, Macedo Maria Cristina Martins de Almeida, Ribeiro Glaciano, Comenalli Marques Junior José Franciscos, Rizzo Silvia Renata Cornélio Parolin, Rabello Guilherme, Langhi Junior Dante Mario

机构信息

Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil; Instituto de Assistência Médica do Servidor Público Estadual (Iamspe), São Paulo, SP, Brazil.

Hospital Guilherme Álvaro e Complexo Hospitalar dos Estivadores, Santos, SP, Brazil.

出版信息

Hematol Transfus Cell Ther. 2024 Apr;46 Suppl 1(Suppl 1):S1-S4. doi: 10.1016/j.htct.2024.02.008. Epub 2024 Mar 11.

Abstract

Patient Blood Management (PBM) is a multidimensional approach that seeks to optimize the use of blood and its components in patients. This matter emerged as a response to the need to reduce unnecessary exposure to blood transfusions and their potential risks. In the past, blood transfusion was often overused resulting in complications and high costs. The advent of Patient Blood Management has caused a paradigm shift, highlighting anemia prevention, bleeding control and maximizing the production of blood cells by the organism itself. Patient Blood Management guidelines include the early identification of anemia, strategies to minimize blood loss during surgery, intraoperative blood conservation techniques, preoperative hemoglobin optimization and evidence-based approaches to the rational use of blood transfusions. Aiming to improve clinical outcomes, decrease transfusion-related complications and reduce associated costs, this multidisciplinary approach counts on doctors, nurses, pharmacists and other healthcare professionals. Based on research and clinical evidence, Patient Blood Management continues to evolve thereby promoting safer, more effective patient-centered practices. Its implementation has proven beneficial in various medical contexts thereby contributing to improvements in the quality of care provided to patients. Our goal with this Consensus is to present readers with a broad and diverse view of Patient Blood Management so that they have the building blocks to implement this new technique.

摘要

患者血液管理(PBM)是一种多维度方法,旨在优化患者血液及其成分的使用。这一理念的出现是为了应对减少不必要的输血暴露及其潜在风险的需求。过去,输血常常被过度使用,导致并发症和高成本。患者血液管理的出现引发了范式转变,强调贫血预防、出血控制以及机体自身血细胞生成的最大化。患者血液管理指南包括贫血的早期识别、手术期间减少失血的策略、术中血液保护技术、术前血红蛋白优化以及合理使用输血的循证方法。为了改善临床结果、减少输血相关并发症并降低相关成本,这种多学科方法依靠医生、护士、药剂师和其他医疗保健专业人员。基于研究和临床证据,患者血液管理不断发展,从而促进更安全、更有效的以患者为中心的实践。其实施已在各种医疗环境中证明是有益的,从而有助于提高为患者提供的护理质量。我们撰写本共识的目的是向读者呈现关于患者血液管理的广泛而多样的观点,以便他们具备实施这项新技术的基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f147/11069064/eb3d7e2cecd7/gr1.jpg

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