Patient Blood Management Is a New Standard of Care to Optimize Blood Health

Goobie, Susan M.

doi:10.1213/ane.0000000000006168

Cited by 18 publications

(9 citation statements)

References 22 publications

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“…Improvement in patient outcomes is the center of PBM with the pillars of perioperative care including interdisciplinary blood conservations modalities across the preoperative, intraoperative, and postoperative course. PBM is the new global standard of care to promote blood health 15 . Pediatric PBM clinical standards for hospitals are published 12 …”

Section: Discussionmentioning

confidence: 99%

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Perioperative management of pediatric patients undergoing juvenile angiofibroma resection. A case series and educational review highlighting patient blood management

Longacre

Seshadri

Adil

et al. 2023

Pediatric Anesthesia

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Background: Juvenile nasopharyngeal angiofibromas are one of the most enigmatic, bloody tumors encountered by otorhinolarygnologists, head and neck surgeons, neurosurgeons, and anesthesiologists. Juvenile nasopharyngeal angiofibromas are rare, benign, highly vascular tumors with a propensity towards aggressive local invasion. Surgery, open or endoscopic, to remove the growth is the primary treatment of choice for Juvenile nasopharyngeal angiofibromas. Historically, surgical resection was associated with massive, rapid blood loss, traditionally managed by blood product transfusion and deliberate hypotension. Preventative management employing multimodal blood conservation strategies should be an essential standard of perioperative care for patients with Juvenile nasopharyngeal angiofibromas. Methods:We describe a contemporary and comprehensive approach in the management of patients with high grade Juvenile nasopharyngeal angiofibromas. This includes surgical strategies such as preemptive external carotid artery embolization, endoscopic surgical approach, and staged operations, as well as anesthetic strategies including antifibrinolytic therapy and acute normovolemic hemodilution. These surgeries, once synonymous with massive transfusion, may potentially be performed without allogeneic blood transfusion, or deliberate hypotension.Aims: Using a case series, the authors introduce a contemporary approach to multimodal, multidisciplinary blood conservation strategies for Juvenile nasopharyngeal angiofibromas surgery. Results:Here in the authors report on an updated contemporary perioperative clinical approach to patients with Juvenile nasopharyngeal angiofibromas. From an anesthetic perspective, we describe the successful use of normal hemodynamic goals, restrictive transfusion strategy, antifibrinolytic therapy, autologous normovolemic hemodilution, and early extubation in the care of three adolescent males with highly invasive tumors. We demonstrate that new surgical and anesthetic strategies have yielded a significant decrease in intraoperative blood loss and eliminated the need for transfusion of autologous red blood cells, which enable improved outcomes. Conclusions:The perioperative approach to elective surgery for Juvenile nasopharyngeal angiofibromas management is presented from a multidisciplinary patient blood management perspective.

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Section: Discussionmentioning

confidence: 99%

“…PBM is the new global standard of care to promote blood health. 15 Pediatric PBM clinical standards for hospitals are published. 12…”

Section: Patient Blood Managementmentioning

confidence: 99%

Perioperative management of pediatric patients undergoing juvenile angiofibroma resection. A case series and educational review highlighting patient blood management

Longacre

Seshadri

Adil

et al. 2023

Pediatric Anesthesia

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“…In adult surgical patients, PBM has reduced overall transfusions, hospital costs, and adverse events. PBM is a new standard of care to optimize blood health 3 . This report focuses on providing insight and guidance to the pediatric anesthesiologists regarding evidence‐based recommended clinical care considerations for pediatric PBM (pPBM).…”

Section: Introductionmentioning

confidence: 99%

Error traps in Pediatric Patient Blood Management in the Perioperative Period

Tan

Murto

Downey

et al. 2023

Pediatric Anesthesia

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Pediatric patients with severe anemia, coagulopathy or clinically significant blood loss are frequently encountered in the perioperative environment. Appropriate management is most effective and safest when harnessing the patient's own hematopoietic system if time permits. In some situations, allogeneic blood component transfusion is necessary to preserve limb and/or life. While necessary to treat anemia, clotting disorders, or improve oxygen delivery, allogeneic blood transfusions can place pediatric patients at risk for respiratory complications, infection, alloimmunization, prolonged hospital stays, multi-organ failure, and death. 1 Therefore, finding ways to reduce unnecessary allogeneic blood transfusions may improve pediatric patient outcomes.Patient Blood Management (PBM) is a patient-centered, systematic, evidence-based approach to improve patient outcomes by managing and preserving the patient's own blood, while promoting patient safety and empowerment. 2 In adult surgical patients, PBM has reduced overall transfusions, hospital costs, and adverse events.PBM is a new standard of care to optimize blood health. 3 This report focuses on providing insight and guidance to the pediatric anesthesiologists regarding evidence-based recommended clinical care considerations for pediatric PBM (pPBM).

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“…PBM has been identified as the new standard of care to promote blood health. 1 PBM initiatives can improve the optimal transfusion of blood components for patients in a safe, clinically effective, and efficient manner using the scarce resource of donated human blood. 2 Anesthesiologists play an important role in PBM in the perioperative environment.…”

mentioning

confidence: 99%

Trends in Gender of Authors of Patient Blood Management Publications

Forkin,

Render,

Staffa

et al. 2023

Anesthesia &Amp; Analgesia

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BACKGROUND: Diverse representation in the field of patient blood management (PBM) may help bring varying perspectives to improve patient care. We assessed trends in gender of first and last authorship of recent PBM publications to evaluate diversity within the field. METHODS: Publications from 10 high-impact anesthesiology and blood transfusion medicine journals between 2017 and 2021 were reviewed using 19 keywords to identify PBM-related articles. Each publication title was reviewed independently to determine whether it met the inclusion criteria. A software program was used to identify the gender of each first and last author for the most common first names. Author gender that could not be identified through this process was determined by querying institutional websites and professional social networks (eg, ResearchGate). Any publication where the gender of the first and/or last author could not be reliably determined was excluded from the analysis. Trends over time were assessed using the Cochran-Armitage test. RESULTS: A total of 2467 publications met the inclusion criteria of the 2873 yielded by the initial search. Gender of the first and last author was identified for 2384 of these publications and included in the final analysis. Approximately 42.8% of publications featured a woman as the first author with the highest from the journals such as the Journal of the American Medical Association (JAMA) (48.7%) and Transfusion (48.1%) and the lowest from the journals such as the British Journal of Anaesthesia (24.1%) and Anesthesia & Analgesia (24.4%). Approximately 32.0% of the publications featured a woman as the last author with the highest being Transfusion (36.9%) and Anaesthesia (31.8%) and the lowest being Anesthesia and Analgesia (18.3%) and Anesthesiology (18.6%). Approximately 57.6% of publications had either a woman as the first or last author while 16.3% of the publications had women as both the first and last authors. Women authors comprised 32.6% of the publications with a single author. Women as the first or last authors did not change significantly over the study period (P = .115 and P = .119, respectively). No significant difference was observed in the percentage of PBM articles with a woman as the first or last author, a woman as the first and last author, or a woman as a single author from 2017 to 2021 (P = .089, P = .055, and P = .226, respectively). CONCLUSIONS: The percentage of women as the first and last authors in PBM publications from the 5-year period of 2017 to 2021 was <50%. Gender equity in PBM authorship was identified as an area for potential future improvement. International mentorship and sponsorship of women remain important in promoting gender equity in PBM authorship.

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Patient Blood Management Is a New Standard of Care to Optimize Blood Health

Cited by 18 publications

References 22 publications

Perioperative management of pediatric patients undergoing juvenile angiofibroma resection. A case series and educational review highlighting patient blood management

Perioperative management of pediatric patients undergoing juvenile angiofibroma resection. A case series and educational review highlighting patient blood management

Error traps in Pediatric Patient Blood Management in the Perioperative Period

Trends in Gender of Authors of Patient Blood Management Publications

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