P Meybohm1, D Fischer2, A Schnitzbauer3, A Zierer4, T Schmitz-Rixen5, G Bartsch6, C Geisen7, K Zacharowski2. 1. Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland. patrick.meybohm@kgu.de. 2. Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland. 3. Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Deutschland. 4. Klinik für Thorax-, Herz- und Thorakale Gefäßchirurgie, Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Deutschland. 5. Klinik für Gefäß- und Endovascularchirurgie, Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Deutschland. 6. Klinik für Urologie und Kinderurologie, Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Deutschland. 7. Institut für Transfusionsmedizin und Immunhämatologie, DRK-Blutspendedienst Baden-Württemberg - Hessen gemeinnützige GmbH, Frankfurt am Main, Deutschland.
Abstract
BACKGROUND: Preoperative anemia has a prevalence of approximately 30% and is one of the strongest predictors of perioperative red blood cell (RBC) transfusion. It is rarely treated although it is an independent risk factor for the occurrence of postoperative complications. Additionally, the high variability in the worldwide usage of RBC transfusions is alarming. Due to these serious deficits in patient care, in 2011 the World Health Organization recommended the implementation of a patient blood management (PBM). OBJECTIVES: This article provides information about PBM as a multidimensional and interdisciplinary approach. MATERIAL AND METHODS: A selective literature search was carried out in the Medline and Cochrane library databases including consideration of national and international guidelines. RESULTS: A PBM promotes the medically and ethically appropriate use of all available resources, techniques and materials in favor of an optimized perioperative patient care. Patients' own resources should be specifically protected, strengthened and used and include (i) diagnosis and therapy of preoperative anemia, (ii) minimizing perioperative blood loss, (iii) blood-conserving surgical techniques, (iv) restriction of diagnostic blood sampling, (v) utilization of individual anemia tolerance, (vi) optimal coagulation and hemotherapy concepts and (vii) guideline-based, rational indications for the use of RBC transfusions. CONCLUSION: A PBM should be advocated as an incentive to evaluate and critically optimize local conditions. An individual, interdisciplinarily structured bundle of different PBM measures has great potential to optimize the quality of patient care and to make it safer.
BACKGROUND: Preoperative anemia has a prevalence of approximately 30% and is one of the strongest predictors of perioperative red blood cell (RBC) transfusion. It is rarely treated although it is an independent risk factor for the occurrence of postoperative complications. Additionally, the high variability in the worldwide usage of RBC transfusions is alarming. Due to these serious deficits in patient care, in 2011 the World Health Organization recommended the implementation of a patient blood management (PBM). OBJECTIVES: This article provides information about PBM as a multidimensional and interdisciplinary approach. MATERIAL AND METHODS: A selective literature search was carried out in the Medline and Cochrane library databases including consideration of national and international guidelines. RESULTS: A PBM promotes the medically and ethically appropriate use of all available resources, techniques and materials in favor of an optimized perioperative patient care. Patients' own resources should be specifically protected, strengthened and used and include (i) diagnosis and therapy of preoperative anemia, (ii) minimizing perioperative blood loss, (iii) blood-conserving surgical techniques, (iv) restriction of diagnostic blood sampling, (v) utilization of individual anemia tolerance, (vi) optimal coagulation and hemotherapy concepts and (vii) guideline-based, rational indications for the use of RBC transfusions. CONCLUSION: A PBM should be advocated as an incentive to evaluate and critically optimize local conditions. An individual, interdisciplinarily structured bundle of different PBM measures has great potential to optimize the quality of patient care and to make it safer.
Authors: Jeffrey L Carson; Michael L Terrin; Helaine Noveck; David W Sanders; Bernard R Chaitman; George G Rhoads; George Nemo; Karen Dragert; Lauren Beaupre; Kevin Hildebrand; William Macaulay; Courtland Lewis; Donald Richard Cook; Gwendolyn Dobbin; Khwaja J Zakriya; Fred S Apple; Rebecca A Horney; Jay Magaziner Journal: N Engl J Med Date: 2011-12-14 Impact factor: 91.245
Authors: Paul A Carless; David A Henry; Annette J Moxey; Dianne O'Connell; Tamara Brown; Dean A Fergusson Journal: Cochrane Database Syst Rev Date: 2010-04-14
Authors: Michael F Leahy; Heather Roberts; S Aqif Mukhtar; Shannon Farmer; Julie Tovey; Val Jewlachow; Tracy Dixon; Peter Lau; Michael Ward; Matthew Vodanovich; Kevin Trentino; Paul C Kruger; Trudi Gallagher; Audrey Koay; Axel Hofmann; James B Semmens; Simon Towler Journal: Transfusion Date: 2013-08-08 Impact factor: 3.157
Authors: Hans Gombotz; Axel Hofman; Peter Rehak; Johann Kurz Journal: Anasthesiol Intensivmed Notfallmed Schmerzther Date: 2011-08-03 Impact factor: 0.698
Authors: David A Henry; Paul A Carless; Annette J Moxey; Dianne O'Connell; Barrie J Stokes; Dean A Fergusson; Katharine Ker Journal: Cochrane Database Syst Rev Date: 2011-03-16
Authors: L T Goodnough; A Maniatis; P Earnshaw; G Benoni; P Beris; E Bisbe; D A Fergusson; H Gombotz; O Habler; T G Monk; Y Ozier; R Slappendel; M Szpalski Journal: Br J Anaesth Date: 2011-01 Impact factor: 9.166
Authors: Thomas Drabinski; Kai Zacharowski; Patrick Meybohm; Alexandra M Rüger; Antonio Ramirez de Arellano Journal: Adv Ther Date: 2020-06-19 Impact factor: 3.845
Authors: Vivienne Keding; Kai Zacharowski; Wolf O Bechstein; Patrick Meybohm; Andreas A Schnitzbauer Journal: World J Surg Oncol Date: 2018-08-07 Impact factor: 2.754