Warner Matthew A, Ferreira Renata, Raphael Jacob, Shore-Lesserson Linda, Grant Michael C, Sykes Hill Shanna, Morewood Gordon, Popescu Wanda M, Schwann Nanette, Guinn Nicole R
From the Department of Anesthesiology & Perioperative Medicine, Mayo Clinic, Rochester, Minnesota.
Department of Anesthesiology, Missoula Anesthesiology and International Heart Institute, Missoula, Montana.
Anesth Analg. 2024 Nov 7. doi: 10.1213/ANE.0000000000006721.
Despite multiple recent guidelines recommending the diagnosis and treatment of anemia before elective cardiac surgery, few institutions have formal programs or methods in place to accomplish this. A major limitation is the perceived financial shortfall and the leadership buy-in required to undertake such an initiative. The purpose of this advisory from the Society of Cardiovascular Anesthesiologists (SCA) Clinical Practice Improvement Committee with endorsement by the Society for the Advancement of Patient Blood Management (SABM) is to provide an overview of preoperative anemia management programs with an emphasis on the associated financial implications. This advisory reviews the evidence for preoperative anemia management programs in both cardiac and noncardiac surgery, discusses options for managing preoperative anemia, provides novel financial modeling regarding the implementation of preoperative anemia management programs, and describes implementation challenges, potential solutions, and opportunities for improvement.
尽管最近有多项指南建议在择期心脏手术前对贫血进行诊断和治疗，但很少有机构制定正式的计划或方法来实现这一目标。一个主要限制是人们认为存在资金缺口以及开展此类倡议所需的领导层支持。本心血管麻醉医师协会（SCA）临床实践改进委员会在患者血液管理促进协会（SABM）认可下发布的这份咨询文件的目的是概述术前贫血管理计划，并重点介绍其相关的财务影响。本咨询文件回顾了心脏手术和非心脏手术中术前贫血管理计划的证据，讨论了术前贫血的管理方案，提供了关于实施术前贫血管理计划的新型财务模型，并描述了实施挑战、潜在解决方案和改进机会。
