患者血液管理的结果,成本效益和道德
Daniel Bolliger1, Andreas Buser2,3, Kenichi A Tanaka4
1Clinic for Anaesthesia, Intermediate Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, University of Basel.
患者血液管理 (PBM) 计划有效地减少红细胞输血和重新手术的风险. 这些计划可能具有成本效益和道德合理性,促进合理使用血液制品.
科学领域:
- 麻醉学 麻醉学
- 输血医学 输血医学
- 医疗保健管理的管理
背景情况:
- 患者血液管理 (PBM) 计划旨在通过尽量减少血液损失和输血需求来优化患者的治疗结果.
- 全基因血制品是一种宝贵而有限的资源,需要合理和基于证据的利用.
研究的目的:
- 审查有关患者血液管理 (PBM) 计划的好处,成本效益和伦理考虑的最新证据.
- 评估PBM对输血率,患者发病率和医疗保健经济学的影响.
主要方法:
- 现有文献的叙述性审查.
- 分析报告PBM计划结果的研究,包括输血率,重新手术,发病率,死亡率和成本效益.
主要成果:
- PBM 计划可以将红细胞输血量减少 20-40%,并降低重新手术的风险.
- 虽然回顾性研究显示PBM的发病率和死亡率降低,但随机对照试验缺乏.
- PBM可能具有成本效益,特别是在低成本的干预措施,如口服铁或抗纤维素催化剂,以及高出血风险的患者中.
结论:
- 患者血液管理 (PBM) 对于合理使用全原血制品至关重要.
- PBM有助于减少输血需求,并尽量减少浪费.
- 通过改善患者的治疗结果和减少输血相关的并发症,PBM符合伦理原则.
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Published on: March 20, 2021
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