Patient Blood Management


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SHORT SUMMARY OF STUDIES

Country

Patients

Effects

Instruments

Publications

USA (Oregon)

2.531 heart surgical patients

Reduction of RBC-transfusions

43% (2003)-> 18% (2007)

multimodal

Brevig J, et al.
Ann Thorac Surg
2009;87:5329

USA (Alabama)

16.000 stationary patients

Reduction of 0.96->0.55 RBC units/discharged patient

Reduction of mean number of units 2->1.5

Transfusiontrigger Guidelines

Oliver JC, et al.
Transfusion.
2014,
press

USA (Englewood)

585 heart surgical patients

Reduction of RBC transfusion 42%->10.6%

Lower complication rates 18.7%->11.1%

Moskowitz D, et al.
Ann ThoracSurg
2010; 90:451 9

Australia (Freemantle)

250000 patients (2008-2011) included 1.100 hearts surgical patients and 9.000 orthopedic patients

Reduction of preoperative anemia 26% (2006/2007)->10% (2010)

Heart Surgery: Reduction of RBC-transfusion 27.5% (2008)-> 12.8% (2011)

Orthopedics: Reduction of EC transfusion 3.6%->2,7%

Diagnostics of anemia, restrictive transfusionstrigger, single-unit-policy

Leahy M, et al.
Transfusion
2014;54(4):1133-45

South Korea

108 patients with knee TEP

Reduction 0.8->0.2 RBC/discharged patient

Reduction RBC-trasnfusion 53.7%->20.4%

Iron i.v., Erythropoietin

Na HS et al.
Transfusion
2011;51(1):118-24

Switzerland (Zurich)

8500 orthpedic patients

Reduction of anemia 17.6%-12.9%

Reduction of RBC transfusion (2008->2009/11):

Hip-TEP: 22%->16%

Knee-TEP 15.5%-5%

Spine 18.6%->8.6%

Diagnosis of anemia, Iron i.v., Erythropoietin, autotransfusion

Theusinger O, et al
Blood Transfus
2014; 12: 195-203

Great Britain (Leeds)

717 orthopedic patients

Reduction of anemia 26% (2008/09)->10% (2010)

Reduction of RBC transfusion

Hip-TEP: 23%->7.6%

Knee-TEP 6.7%->0%

Introduction of modified protocols for anemia treatment, blood saving steps and transfusionstrigger

Kotze, A. et al.
BrJ Anaesthesia
2012;108 (6): 94352

Netherlands (Leiden)

683 orthopedic patients

Use of erythropoietin for anemia treatment: Reduction of RBC transfusion 26%->7.6%

Use of autotransfusion: Reduction of RBC transfusion 29%->19%

Autotransfusion,

erythropoietin

So-Osman et al. al.
Anesthesiology
2014; in press