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Getting patient blood management Pillar 1 right in the Asia-Pacific: a call for action

Hairil Rizal Abdullah1, Ai Leen Ang2, Bernd Froessler3

  • 1Department of Anaesthesiology, Singapore General Hospital, Singapore.

Singapore Medical Journal
|May 3, 2019
PubMed

Insights

Preoperative anaemia, common in the Asia-Pacific, can be managed with patient blood management (PBM) Pillar 1. Implementing PBM strategies, like iron treatment, reduces surgical risks and improves patient outcomes.

Area of Science:

  • Anesthesiology
  • Hematology
  • Healthcare Management

Background:

  • Preoperative anaemia is a prevalent issue in the Asia-Pacific region.
  • Iron deficiency anaemia (IDA) is a significant modifiable risk factor impacting surgical outcomes.
  • Patient Blood Management (PBM) Pillar 1 offers a framework to address preoperative anaemia.

Purpose of the Study:

  • To examine the implementation of PBM Pillar 1 across diverse healthcare systems in the Asia-Pacific.
  • To identify challenges encountered during PBM implementation.
  • To propose actionable measures for effective PBM integration.

Main Methods:

  • Analysis of PBM implementation strategies in four distinct healthcare systems.
  • Identification of barriers and facilitators to PBM adoption.
  • Development of recommendations for preoperative anaemia management.

Main Results:

  • Key measures include timely anaemia testing, patient education on anaemia risks and benefits of treatment, and tailored IDA treatment (prioritizing intravenous iron when necessary).
  • Transfusion should not be the default management for preoperative anaemia.
  • Multidisciplinary collaboration and demonstration of improved outcomes and cost-effectiveness are crucial for PBM promotion.

Conclusions:

  • PBM Pillar 1 implementation is feasible, even starting with small initiatives.
  • Integrating PBM, especially for preoperative patients, is a practical and beneficial first step in any healthcare setting.
  • Addressing preoperative anaemia through PBM can significantly reduce morbidity and mortality.

Keywords:
Asia Pacificanaemiairon deficiencypatient blood managementpreoperative

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