Strategies to preempt and reduce the use of blood products: an Australian perspective

Purpose of review: Evidence-based patient blood management (PBM) is aimed at achieving better patient outcomes by relying on a patient's own blood rather than on donor blood. This review covers the rationale behind PBM, the treatment modalities involved and the drivers to adopt PBM as a new sta...

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Main Authors: Hofmann, Axel, Farmer, Shannon, Towler, Simon
Format: Journal Article
Published: Lippincott, Williams & Wilkins 2012
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/49764
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author Hofmann, Axel
Farmer, Shannon
Towler, Simon
author_facet Hofmann, Axel
Farmer, Shannon
Towler, Simon
author_sort Hofmann, Axel
building Curtin Institutional Repository
collection Online Access
description Purpose of review: Evidence-based patient blood management (PBM) is aimed at achieving better patient outcomes by relying on a patient's own blood rather than on donor blood. This review covers the rationale behind PBM, the treatment modalities involved and the drivers to adopt PBM as a new standard of care.Recent findings: Transfusion rates vary significantly between comparable countries; they also vary between centers for matched patients in standardized elective surgical interventions. Preoperative anemia, perioperative blood loss and liberal transfusion triggers are the main predictors for transfusion and pose risks to the patient. PBM is mitigating these risks by optimizing the patient's native red cell mass, minimizing blood loss, optimizing the physiological reserve of anemia and preempting transfusions. A growing number of studies show that transfusion is associated in a dose-dependent relationship with increased morbidity, mortality and hospital length of stay. Evidence suggests that this relationship is not merely associative but causal. Furthermore, the over-ageing population of the developed world leads to a growing gap between supply and demand of blood, the safety of donor blood remains unpredictable and the cost of transfusion is much higher than previously estimated.Summary: High transfusion variability, adverse transfusion outcomes, limited evidence for the benefit of transfusion particularly in elective patients and high cost of transfusion are challenging the traditional transfusion paradigm. National and state-wide initiatives are underway in Australia to broadly implement PBM and PBM programs as a new and cost-effective standard of care in the public health system.
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publishDate 2012
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spelling curtin-20.500.11937-497642017-03-15T22:56:41Z Strategies to preempt and reduce the use of blood products: an Australian perspective Hofmann, Axel Farmer, Shannon Towler, Simon blood loss anemia hypoxia transfusion patient blood management Purpose of review: Evidence-based patient blood management (PBM) is aimed at achieving better patient outcomes by relying on a patient's own blood rather than on donor blood. This review covers the rationale behind PBM, the treatment modalities involved and the drivers to adopt PBM as a new standard of care.Recent findings: Transfusion rates vary significantly between comparable countries; they also vary between centers for matched patients in standardized elective surgical interventions. Preoperative anemia, perioperative blood loss and liberal transfusion triggers are the main predictors for transfusion and pose risks to the patient. PBM is mitigating these risks by optimizing the patient's native red cell mass, minimizing blood loss, optimizing the physiological reserve of anemia and preempting transfusions. A growing number of studies show that transfusion is associated in a dose-dependent relationship with increased morbidity, mortality and hospital length of stay. Evidence suggests that this relationship is not merely associative but causal. Furthermore, the over-ageing population of the developed world leads to a growing gap between supply and demand of blood, the safety of donor blood remains unpredictable and the cost of transfusion is much higher than previously estimated.Summary: High transfusion variability, adverse transfusion outcomes, limited evidence for the benefit of transfusion particularly in elective patients and high cost of transfusion are challenging the traditional transfusion paradigm. National and state-wide initiatives are underway in Australia to broadly implement PBM and PBM programs as a new and cost-effective standard of care in the public health system. 2012 Journal Article http://hdl.handle.net/20.500.11937/49764 Lippincott, Williams & Wilkins restricted
spellingShingle blood loss
anemia
hypoxia
transfusion
patient blood management
Hofmann, Axel
Farmer, Shannon
Towler, Simon
Strategies to preempt and reduce the use of blood products: an Australian perspective
title Strategies to preempt and reduce the use of blood products: an Australian perspective
title_full Strategies to preempt and reduce the use of blood products: an Australian perspective
title_fullStr Strategies to preempt and reduce the use of blood products: an Australian perspective
title_full_unstemmed Strategies to preempt and reduce the use of blood products: an Australian perspective
title_short Strategies to preempt and reduce the use of blood products: an Australian perspective
title_sort strategies to preempt and reduce the use of blood products: an australian perspective
topic blood loss
anemia
hypoxia
transfusion
patient blood management
url http://hdl.handle.net/20.500.11937/49764