Diagnostic, preventive and therapeutic evidence in obstetrics for the implementation of patient blood management: a systematic review protocol

Abstract

IntroductionPatientblood management (PBM) is defined as the application of evidence-based diagnostic, preventive and therapeutic approaches designed to maintain haemoglobin concentration, optimise haemostasis and minimise blood loss in an effort to improve patient outcome. We propose a protocol for the assessment of the evidence of diagnostic, preventive and therapeutic approaches for the management of relevant outcomes in obstetrics with the aim to create a framework for PBM implementation.Methods and analysisDiagnostic, preventive and therapeutic tools will be considered in the gynaecological conditions and obstetrics setting (antenatal care, peripartum care and maternity care). For each condition, (1) clinical questions based on prioritised outcomes will be developed; (2) evidence will be retrieved systematically from electronic medical literature (MEDLINE, EMBASE, the Cochrane Library, Web of Science, and CINAHL); (3) quality of the reviews will be assessed using the AMSTAR (A Measurement Tool to Assess Systematic Reviews) checklist; quality of primary intervention studies will be assessed using the risk of bias tool (Cochrane method); quality of diagnostic primary studies will be assessed using QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies); (4) the Grading of Recommendations Assessment, Development and Evaluation method will be applied to rate the quality of the evidence and to develop recommendations.Ethics and disseminationFor each diagnostic, preventive or therapeutic intervention evaluated, a manuscript comprising the evidence retrieved and the recommendation produced will be provided and published in peer-reviewed journals. Ethical approval is not required.

Oral iron‐based interventions for prevention of critical outcomes in pregnancy and postnatal care: An overview and update of systematic reviews

“…Knowledge of the relative effects of the different types of iron‐based therapies for pregnant women can be helpful to prevent important adverse outcomes. This work aims to provide an overview of the evidence from systematic reviews regarding oral iron‐based interventions to prevent critical outcomes in pregnancy, to facilitate policymakers and stakeholders in the delivery of recommendations . This work has been proposed within a framework for adopting Patient Blood Management (PBM), provided in the Region of Umbria, in the obstetrics setting .…”

“…This work aims to provide an overview of the evidence from systematic reviews regarding oral iron‐based interventions to prevent critical outcomes in pregnancy, to facilitate policymakers and stakeholders in the delivery of recommendations . This work has been proposed within a framework for adopting Patient Blood Management (PBM), provided in the Region of Umbria, in the obstetrics setting . The PBM concept is to optimize erythropoiesis, minimize blood loss and bleeding, and optimize the physiological reserve of anemia through the development of clinical guidelines to assist clinicians, transfusions, obstetricians and anesthesiologists about appropriate care in obstetrics.…”

Blood Service: Efficiency and Safety Improvement

“…«Рестриктивная/ограничительная» тактика применения гемотрансфузий и внедрение политики управления потреблением компонентов крови является общепризнанной для больничных организаций [12]. Взаимодействие уровней организации, планирования потребности компонентов крови -управление запасами крови -своевременное применение научно обоснованных медицинских и хирургических концепций, направленных на поддержание концентрации гемоглобина, оптимизацию гемостаза и минимизацию кровопотери в целях улучшения результатов лечения пациентов [13][14][15][16][17].…”