Pillar 2: Minimising bleeding and blood loss

Bisbe, E.; Moltó, L.

doi:10.1016/j.bpa.2012.12.004

Cited by 28 publications

(23 citation statements)

References 67 publications

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“…Üçüncü sütun ise hastanın kan kaybını tolere etmesini sağlayacak kompansatuar mekanizmalarını optimumda tutmak için yapılması gerekenleri özetler. Her bir sütunun ameliyat öncesinde, ameliyat sırasında ve sonrasında uygulanması gerekenlerle ilgili üç ayrı aşaması vardır (16)(17)(18)(19)(20) . İlk iki sütuna yeteri kadar özen gösterildiğinde sıklıkla can simidimiz olan kompansatuar mekanizmaların devreye girmesine gerek kalmaz.…”

Section: Hky Uygulamaları Neleri Içerir?unclassified

Patient Blood Management

Heper¹

2018

İKSST

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ÖZHasta Kanı Yönetimi (HKY), gereksiz transfüzyonları önlemek yanında hastanın transfüzyon alma olasılığını en aza indirmeye ve kendi kan rezervini optimize etmeye yönelik tüm uygulamaları içeren bir kavramdır. En çok elektif cerrahiye hazırlanan hastalarda uygulanmakta olup transfüzyon miktarında önemli oranda azalma, maddi olarak tasarruf ve hasta açısından daha iyi tıbbi sonuçlar sağladığı gösterilmiştir. Bu makalede, Dünya Sağlık Örgütü'nün de sağlık uygulamalarının ayrılmaz bir parçası olması gerektiğini ilan ettiği HKY'nin temel noktaları özetlenmiştir.Anahtar kelimeler: hasta kan yönetimi, kan elemanları transfüzyonu, otolog kan transfüzyon, anemi, elektif cerrahi işlemler ABSTRACT Patient Blood Management (PBM) is a concept that includes all practices to prevent unnecessary transfusions, to minimize the possibility of the patient receiving transfusion and to optimize the patient's own blood reserve. It is most frequently used in patients being prepared foe elective surgery, and it has been shown that it is very effective in providing a significant reduction in the amount of transfusions, financial savings and better medical outcomes for the patient. This paper summarizes the key points of the PBM, which the World Health Organization has declared that it should be an integral part of health practices.

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Section: Hky Uygulamaları Neleri Içerir?unclassified

Patient Blood Management

Heper¹

2018

İKSST

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“…Moreover, the pressure and tidal volume of ventilator should be adjusted to decrease the mean intrathoracic pressure because positive pressure ventilation under general anesthesia may have an adverse effect on venous return23).…”

Section: Strategy To Minimize Blood Lossmentioning

confidence: 99%

“…Intraoperative shed blood can be collected and processed for re-use using RBC salvage and reinfusion system23). Cell saver, one intraoperative auotologous transfusion technique in which drained blood is collected, washed, and reinjected, can also be considered.…”

Section: Strategy To Minimize Blood Lossmentioning

confidence: 99%

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Management of Blood Loss in Hip Arthroplasty: Korean Hip Society Current Consensus

et al. 2017

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The volume of hip arthroplasty is stiffly increasing because of excellent clinical outcomes, however it has not been shown to decrease the incidence of transfusions due to bleeding related to this surgery. This is an important consideration since there are concerns about the side effects and social costs of transfusions. First, anemia should be assessed at least 30 days before elective hip arthroplasty, and if the subject is diagnosed as having anemia, an additional examination of the cause of the anemia should be carried and steps taken to address the anemia. Available iron treatments for anemia take 7 to 10 days to facilitate erythropoiesis, and preoperative iron supplementation, either oral or intravenous, is recommended. When using oral supplements for iron storage, administer elemental iron 100 mg daily for 2 to 6 weeks before surgery, and calculate the dose using intravenous supplement. Tranexamic acid (TXA) is a synthetic derivative of the lysine component, which reduces blood loss by inhibiting fibrinolysis and clot degradation. TXA is known to be an effective agent for reducing postoperative bleeding and reducing the need for transfusions in primary and revision total hip arthroplasties. Patient blood management has improved the clinical outcome after hip arthroplasty through the introduction and research of various agents, thereby reducing the need for allogeneic blood transfusions and reducing the risk of transfusion-related infections and the duration of hospitalizations.

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“…A variety of approaches have been employed to reduce perioperative blood loss [52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67]. The development of protocols involves multidisciplinary collaboration between surgeons, anesthesiologists, hematologists, transfusion medicine and pharmacy.…”

Section: Reducing Perioperative Blood Lossmentioning

confidence: 99%

Transfusion Medicine: Time for a Change: Patient Blood Management and the Ontario ONTraC Program

Freedman¹

2016

J Perioper Crit Intensive Care Nurs

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Despite increasing recognition of the potential adverse effects of blood transfusion there is evidence that the procedure is over-utilized and often inappropriately and unnecessarily administered. Patient Blood Management (PBM) is a recent world-wide initiative to optimize transfusion therapy by employing preoperative and perioperative maneuvers and alternatives to avoid unnecessary blood transfusion. These approaches are, however, not restricted to the surgical setting, but may be applied whenever transfusion is contemplated. A key component of PBM is the appropriate management of anemia, a prime determinant of transfusion. Another is tolerance of anemia through the use of restrictive transfusion thresholds for transfusion and of a single unit at a time policy. Among a number of options at surgery, antifibrinolytics have proven effective at reducing blood loss and transfusion. Burgeoning literature demonstrates that PBM (also known as Blood Conservation or as 'Bloodless Medicine/Surgery') is costeffective while improving patient outcomes and conserving the blood supply. Data from the ONTraC program in Ontario are described herein to illustrate the effectiveness of PBM approaches.

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Pillar 2: Minimising bleeding and blood loss

Cited by 28 publications

References 67 publications

Patient Blood Management

Patient Blood Management

Management of Blood Loss in Hip Arthroplasty: Korean Hip Society Current Consensus

Transfusion Medicine: Time for a Change: Patient Blood Management and the Ontario ONTraC Program

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