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Patient blood management, what does this actually mean for neonates and infants?
G L Crighton1,2, H V New3,4, H G Liley5,6
1Royal Children's Hospital, Melbourne, Victoria, Australia.
Insights
Patient blood management (PBM) optimizes transfusion therapy for better outcomes. This review proposes specific PBM definitions and elements for neonates and children, addressing a gap in current pediatric transfusion practices.
Area of Science:
- Pediatric Transfusion Medicine
- Neonatal Hematology
- Patient Blood Management
Background:
- Patient blood management (PBM) is an evidence-based approach to optimize transfusion therapy.
- Established PBM programs exist for adults, but definitions and implementation lag in neonates and children.
- Neonates and infants are frequently transfused but often underrepresented in clinical trials.
Purpose of the Study:
- To review the literature on neonatal and pediatric transfusion medicine.
- To propose specific definitions and elements for neonatal patient blood management.
- To address the gap in PBM implementation for pediatric populations.
Main Methods:
- Literature review of neonatal and pediatric transfusion medicine.
- Analysis of existing PBM principles and their applicability to neonates.
- Synthesis of findings to propose neonatal PBM elements.
Main Results:
- Significant differences exist between adult and neonatal populations regarding transfusion needs and management.
- Current PBM strategies for adults may not be directly transferable to neonates.
- Key elements for neonatal PBM include anemia management, blood loss prevention, and tolerance improvement.
Conclusions:
- Neonatal patient blood management requires tailored definitions and specific implementation strategies.
- Further research and dedicated PBM programs are needed for neonates and children.
- Implementing neonatal PBM can improve outcomes and optimize transfusion use in this vulnerable population.
Abstract:
Patient blood management (PBM) refers to an evidence-based package of care that aims to improve patient outcomes by optimal use of transfusion therapy, including managing anaemia, preventing blood loss and improving anaemia tolerance in surgical and other patients who may need transfusion. In adults, PBM programmes are well established, yet the definition and implementation of PBM in neonates and children lags behind. Neonates and infants are frequently transfused, yet they are often under-represented in transfusion trials. Adult PBM programmes may not be directly applicable to these populations. We review the literature in neonatal (and applicable paediatric) transfusion medicine and propose specific neonatal PBM definitions and elements.
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