在选择性手术中对外科手术前贫血的管理. 根据Delphi-UCLA方法论的结论和建议
V Moral1, A Abad Motos2, C Jericó3
1Department of Anaesthesia. Hospital Universitario Sant Pau and Universidad Autónoma de Barcelona, Barcelona, Spain.
Revista espanola de anestesiologia y reanimacion
|April 26, 2024
概括
患者血液管理 (PBM) 计划对手术患者至关重要. 这项研究在PBM建议方面达到了高度共识,强调了手术前贫血的诊断,治疗和限制性输血标准,以改善患者的治疗结果.
科学领域:
- 麻醉学 麻醉学
- 血液学 血液学 血液学
- 内部医学 内部医学
- 护理的质量 护理的质量
- 临床安全 临床安全
背景情况:
- 手术前贫血影响到三分之一的手术患者,增加了输血风险,并发症和成本.
- 患者血液管理 (PBM) 计划对于管理外科手术期间贫血和改善患者结果至关重要.
- 2021年手术后增强恢复 (ERAS) 途径包括许多对PBM的间接建议.
研究的目的:
- 使用RAND/UCLA Delphi方法制定一个共识文件.
- 在临床实践中增加ERAS 2021 PBM建议的采用和优先考虑.
主要方法:
- 组建了一个由6名专家组成的协调小组.
- 基于ERAS 2021 PBM建议的Delphi调查在线进行.
- 共识被定义为在10分利克特等级上平均得分为9分或更高.
主要成果:
- 对于大多数PBM建议,达成了高度共识 (平均得分>9).
- 关键建议包括:强制性手术前贫血诊断和治疗,在稳定的患者中不进行中度贫血 (Hb 8-10 g/dL) 的例行手术前输血,普遍限制性输血标准,以及手术后贫血的治疗.
- 一个问题没有达成共识,三个问题得分高于8.
结论:
- 关于PBM建议的重要性和支持PBM建议的证据存在广泛共识.
- 这些发现有助于在医院实施PBM计划.
- 该研究强调了改善外科手术期间贫血管理和患者治疗结果的关键领域.
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