Filipescu Daniela, Ștefan Mihai-Gabriel, Turconi Șerban Ion Bubenek, Corneci Dan, Droc Gabriela, Goicea Raluca, Grigoraș Ioana, Grințescu Ioana M, Mirea Liliana, Predoi Cornelia, Ristescu Anca-Irina, Negoiță Silvius, Săndesc Dorel, Scărlătescu Ecaterina, Văleanu Liana, Andrei Ștefan, Tomescu Dana
"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
"Prof. C. C. Iliescu" Emergency Institute for Cardiovascular Diseases, Bucharest, Romania.
Blood Transfus. 2025 May-Jun;23(3):232-241. doi: 10.2450/BloodTransfus.776. Epub 2024 Oct 15.
In 2018, Romania established national guidelines for patient blood management (PBM), endorsed by the Romanian Society of Anesthesia and Intensive Care (SRATI) and approved by the Ministry of Health. These guidelines emphasize managing anemia, coagulation issues, and the cautious use of allogeneic transfusions to improve patient outcomes.
A national survey was conducted among Romanian anesthesiologists to assess PBM guideline adoption. It included 38 questions addressing PBM strategies, resources, transfusion practices, and barriers to implementation. The survey was distributed via email to the SRATI database.
Out of 512 professionals who opened the survey, 74% had adopted some PBM measures, and 97% recognized PBM's efficacy in improving outcomes. However, only 33% of anesthesiologists worked in hospitals with formal PBM groups, and 39% had attended PBM-related educational events. Preoperative anemia management was inconsistent, with only 33.5% routinely treating anemia. Access to diagnostic and therapeutic tools was limited; transferrin saturation testing was available in 27% of cases, and erythropoietin was used in 24%. Despite these limitations, 72% of respondents treated anemia with intravenous iron.The main challenges to implementation included insufficient time for pre-surgical assessments, lack of standardized procedures, and difficulties in surgeon-anesthetist collaboration.
The survey highlights the need for systemic improvements in PBM adoption. Recommendations include enhancing organizational structures, standardizing protocols, and improving interdisciplinary collaboration to boost PBM implementation in Romania. While progress has been made, a national program with dedicated funding and auditing could facilitate widespread PBM integration into clinical practice.
2018年，罗马尼亚制定了患者血液管理（PBM）国家指南，该指南得到罗马尼亚麻醉与重症监护学会（SRATI）的认可，并经卫生部批准。这些指南强调管理贫血、凝血问题以及谨慎使用异体输血以改善患者预后。
对罗马尼亚麻醉医生进行了一项全国性调查，以评估PBM指南的采用情况。调查包括38个问题，涉及PBM策略、资源、输血实践以及实施障碍。该调查通过电子邮件发送至SRATI数据库。
在512名打开调查问卷的专业人员中，74%采取了一些PBM措施，97%认可PBM在改善预后方面的功效。然而，只有33%的麻醉医生在设有正式PBM小组的医院工作，39%的人参加过与PBM相关的教育活动。术前贫血管理不一致，只有33.5%的人常规治疗贫血。诊断和治疗工具的获取有限；27%的病例可进行转铁蛋白饱和度检测，24%的病例使用促红细胞生成素。尽管存在这些限制，72%的受访者使用静脉铁剂治疗贫血。实施的主要挑战包括术前评估时间不足、缺乏标准化程序以及外科医生与麻醉医生协作困难。
该调查凸显了在PBM采用方面进行系统性改进的必要性。建议包括加强组织结构、规范方案以及改善跨学科协作，以促进罗马尼亚PBM的实施。虽然已取得进展，但一个有专项资金和审计的国家项目可推动PBM广泛融入临床实践。
