Patient blood management, what does this actually mean for neonates and infants?

Crighton, Gemma; New, Helen; Liley, Helen; Stanworth, Simon

doi:10.1111/tme.12525

Cited by 18 publications

(22 citation statements)

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“…While evidence‐based criteria and expert consensus guidelines for clinically appropriate transfusion have been published, practitioners continue to transfuse patients outside these recommended criteria and best practice guidelines without sufficient demonstration of benefit to the recipient. The implementation of a comprehensive PBM program has been shown to decrease blood transfusion, decrease morbidity and mortality and decrease hospital costs …”

Section: Introductionmentioning

confidence: 99%

“…The implementation of a comprehensive PBM program has been shown to decrease blood transfusion, decrease morbidity and mortality and decrease hospital costs. 4,6,10 Therefore, comprehensive multimodal PBM is the new standard of care to manage anemia and hemostasis and has been recommended by the World Health Organization, the American Society of Anesthesiologists, the European Society of Anaesthesiology, and the Australian National Blood Authority. 1,21,26,34 Management of pediatric bleeding and blood product transfusion presents distinctive considerations.…”

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confidence: 99%

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Society for the advancement of blood management administrative and clinical standards for patient blood management programs. 4th edition (pediatric version)

Goobie¹,

Gallagher²,

Gross

et al. 2019

Pediatric Anesthesia

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Summary Patient Blood Management is the timely application of evidence‐based medical and surgical concepts designed to maintain hemoglobin concentration, optimize hemostasis, and minimize blood loss to improve patient outcomes. Conceptually similar to a “bundle” strategy, it is designed to improve clinical care using comprehensive evidence‐based treatment strategies to manage patients with potential or ongoing critical bleeding, bleeding diathesis, critical anemia, and/ or a coagulopathy. Patient Blood Management includes multimodal strategies to screen, diagnose and properly treat anemia, coagulopathies and minimize bleeding, using goal‐directed therapy and leverages a patient's physiologic ability to adapt to anemia while definitive treatment is undertaken. Allogeneic blood component transfusion is one traditional therapeutic modality out of many for managing blood loss and anemia and, while it may be the best choice in certain situations, other effective and more appropriate options are available and should be used in conjunction or alone. Therefore, comprehensive Patient Blood Management is the new standard of care to prevent and manage anemia and optimize hemostasis and has been recommended by the World Health Organization, the American Society of Anesthesiologists, the European Society of Anaesthesiology and the Australian National Blood Authority. While there is a plethora of expert consensus and good practice guidelines published for blood component transfusion from multiple professional organizations and societies, there remains a need for more comprehensive and broader standards of patient medical management to proactively reduce the risk of exposure to allogeneic transfusions. In 2010, the Society for Advancement of Blood Management published the first comprehensive standards to address the administrative and clinical components of an effective, patient‐centered Patient Blood Management program. Recognizing the need to reduce inappropriate transfusions, some professional organizations have placed their emphasis on transfusion guidelines. In contrast, the focus of the Society for Advancement of Blood Management Standard is on the centrality of the patient and the full spectrum of therapeutic strategies needed to improve clinical outcomes in patients at risk for blood loss or anemia, thereby reducing avoidable transfusions as well. The Standards are meant not to replace, but to complement transfusion guidelines by more completely addressing the need for a multi‐modal clinical approach with the goal to improve patient outcomes. Compared to adult programs, Pediatric Patient Blood Management programs are currently not commonly accepted as standard of care for pediatric patients. This is partly due to the fact that, until recently, there was a paucity of robust evidence‐based literature and expert consensus guidelines on pediatric PBM. Managing pediatric bleeding and blood product transfusion presents a unique set of challenges. The main goal of transfusion is to correct or avoid imminent inadequate oxygen c...

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Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Society for the advancement of blood management administrative and clinical standards for patient blood management programs. 4th edition (pediatric version)

Goobie¹,

Gallagher²,

Gross

et al. 2019

Pediatric Anesthesia

View full text Add to dashboard Cite

show abstract

“…Crighton et al . () highlight that the evidence base for transfusion in neonates lags behind that in adults and propose specific PBM criteria for neonates. Gastrointestinal bleeding is a common medical and surgical emergency, and Oakland et al .…”

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confidence: 99%

“…Unnecessary transfusions have been highlighted in the 'Choosing Wisely' campaigns in Canada, the United States and the UK (Box 1).In this special issue of Transfusion Medicine, we have invited a series of reviews that cover many of the activities and areas of PBM.We have always welcomed articles on PBM but here have commissioned a series of articles to bring together state-of-the-art reviews from experts across the many areas of clinical practice.In this issue, Bielby and Moss (2018) explain how the role of transfusion practitioners has evolved from enhancing haemovigilance and patient safety to establishing PBM and good transfusion practice across their hospitals.Roy and Pavord (2018) review the management of anaemia in pregnancy and post-partum, which affects one in four pregnant women in Europe. Crighton et al (2018) highlight that the evidence base for transfusion in neonates lags behind that in adults and propose specific PBM criteria for neonates. Gastrointestinal bleeding is a common medical and surgical emergency, and Oakland et al (2018) provide practical advice on transfusion management in stable gastrointestinal haemorrhage, whereas Flint et al (2018) discuss the most recent approach to transfusion in major haemorrhage.…”

mentioning

confidence: 99%

“…Roy and Pavord (2018) review the management of anaemia in pregnancy and post-partum, which affects one in four pregnant women in Europe. Crighton et al (2018) highlight that the evidence base for transfusion in neonates lags behind that in adults and propose specific PBM criteria for neonates. Gastrointestinal bleeding is a common medical and surgical emergency, and Oakland et al (2018) provide practical advice on transfusion management in stable gastrointestinal haemorrhage, whereas Flint et al (2018) discuss the most recent approach to transfusion in major haemorrhage.…”

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confidence: 99%

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