临床实践中的合理输血:步步为营

Ratti Ram Sharma
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引用次数: 0

摘要

输血疗法经历了从全血输注到高度专业化的血液成分疗法的重大演变。文献中有足够的证据表明,有一半的输血患者实际上并不需要输血,因为他们的血红蛋白可以通过其他方法得到改善。患者血液管理(PBM)的引入标志着临床输血实践和贫血管理模式的转变,强调以患者为中心。患者血液管理策略旨在保存和改善患者的血液,从而减少对异体输血的需求。PBM 策略包括治疗贫血、纠正凝血功能障碍和尽量减少失血。每家医疗机构都应计划将 PBM 作为一项多学科、多专业的计划来实施,这需要临床医生、公共卫生专业人员和医院管理部门的通力合作。因此,PBM 的实施需要全面的业务计划、循证输血指南、教育和临床决策支持系统。数据采集、分析、审计和报告在持续改善医疗系统和提高患者安全方面发挥着至关重要的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Rational Transfusion in Clinical Practice: Walking the Tight Rope
Transfusion therapy has undergone a significant evolution from whole blood transfusions to highly specialized blood component therapy. There is enough evidence in the literature that estimates that half of the transfusions given to the patients were actually not required as their hemoglobin can be improved with the help of alternative methods. The introduction of patient blood management (PBM) marks a paradigm shift in clinical transfusion practice and anemia management, emphasizing a patient-centric approach. PBM strategies aim to preserve and improve the patient’s blood, thereby reducing the need for allogeneic blood transfusions. PBM strategies include treating anemia, correcting coagulopathy, and minimizing blood loss. Every healthcare facility should plan to implement PBM as a multidisciplinary and multi-professional program, requiring collaboration from clinicians, public health professionals, and hospital administration. Thus, PBM implementation requires a comprehensive business plan, evidence-based transfusion guidelines, education, and a clinical decision support system. Data acquisition, analysis, audits, and reports play a crucial role in continuously improving the healthcare system and enhancing patient safety.
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