PBM: Now more than ever necessary

García‐Erce, José Antonio; Jericó, Carlos Rilova; Abad‐Motos, Ane; García, Jesús Rodríguez; Caamaño, María Luisa Antelo; Morera, J.; Lapeña, C Sola; Arroyo, José Luis; Fuertes, F Fernández; Marcos, Saioa Zalba; Rodriguez, German; Morales, María Jesús Laso; Cabrera, José Luis; Chica, E; Recasens, Valle; Zabalegui, Adelaida; Balén, E; Urrechaga, Eloísa; Abad‐Gurumeta, Alfredo; Díaz, Manuel Quintana

doi:10.1016/j.redare.2021.03.016

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…Based on the results of this study, the management of donations is especially important at the present time, marked by the continuity of COVID-19 [ 22 , 23 ]. The current pandemic situation caused by COVID-19 has created an environment in which the application of these practices is even more relevant [ 24 ], as blood is considered a scarce and very valuable resource with a limited storage time.…”

Section: Discussionmentioning

confidence: 99%

“…PBM programs are a set of therapeutic strategies whose main objective is to improve patients’ conditions by focusing on preventing or avoiding the over-transfusion of blood, as this can lead to serious complications [ 22 , 23 ]. Our study was oriented toward studies carried out in the United States, where it has been shown that COVID-19 has had a clearly negative effect with regard to blood donations, which has led to the need to adapt policies against this decline [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

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A Cohort Study in Intensive Care Units: Health Decisions Related to Blood Transfusion during the COVID-19 Pandemic

Juárez‐Vela

García-Erce

Gea-Caballero

et al. 2022

JCM

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Critically ill polytrauma patients with hemorrhage require a rapid assessment to initiate hemostatic resuscitation in the shortest possible time with the activation of a massive transfusion or a critical hemorrhage management protocol. The hospital reality experienced during the COVID-19 pandemic in all countries was critical, as it was in Spain; according to the data published daily by the Ministry of Health on its website, during the period of this study, the occupancy rate of intensive care units (ICUs) by patients diagnosed with the novel coronavirus disease (COVID-19) rose to 23.09% in Spain, even reaching 45.23% at the end of January 2021. We aimed to analyze the changes observed during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic period regarding the effectiveness of Spanish ICUs in terms of mortality reduction. We present a cross-sectional study that compares two cohorts of patients admitted to ICUs across all autonomous communities of Spain with a diagnosis of polytrauma. Results: Only age was slightly higher at admission during the first wave of the pandemic (47.74 ± 18.65 vs. 41.42 ± 18.82 years, p = 0.014). The transfusion rate during the pandemic increased by 10.4% compared to the previous stage (p = 0.058). Regarding hemostatic components, the use of tranexamic acid increased from 1.8% to 10.7% and fibrinogen concentrates from 0.9% to 1.9%. In the case of prothrombin complex concentrates, although there was a slight increase in their use, there were no significant differences during the pandemic compared to the previous period. Conclusion: Mortality showed no difference before and during the pandemic, despite the observed change in the transfusion policy. In summary, the immediate and global implementation of patient blood management (PBM) based on clinical transfusion algorithms should be mandatory in all hospitals in our country.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Cohort Study in Intensive Care Units: Health Decisions Related to Blood Transfusion during the COVID-19 Pandemic

Juárez‐Vela

García-Erce

Gea-Caballero

et al. 2022

JCM

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Enhanced recovery after surgery: a narrative review on patient blood management recommendations

et al. 2023

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Related Factors of Anemia in Critically Ill Patients: A Prospective Multicenter Study

Juárez‐Vela

Andrés-Esteban

Gea-Caballero

et al. 2022

JCM

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Anemia is common in critically ill patients; almost 95% of patients admitted to intensive care units (ICUs) have hemoglobin levels below normal. Several causes may explain this phenomenon as well as the tendency to transfuse patients without adequate cause: due to a lack of adherence to protocols, lack of supervision, incomplete transfusion request forms, or a lack of knowledge about the indications, risks, and costs of transfusions. Daily sampling to monitor the coagulation parameters and the acid–base balance can aggravate anemia as the main iatrogenic factor in its production. We studied the association and importance of iatrogenic blood loss and other factors in the incidence of anemia in ICUs. We performed a prospective, observational, multicenter study in five Spanish hospitals. A total of 142 patients with a median age of 58 years (IQI: 48–69), 71.83% male and 28.17% female, were admitted to ICUs without a diagnosis of iatrogenic anemia. During their ICU stay, anemia appeared in 66.90% of the sample, 95 patients, (95% CI: 58.51–74.56%). Risk factors associated with the occurrence of iatrogenic anemia were arterial catheter insertion (72.63% vs. 46.81%, p-value = 0.003), venous catheter insertion (87.37% vs. 72.34%, p-value = 0.023), drainages (33.68% vs. 12. 77%, p-value = 0.038), and ICU stay, where the longer the stay, the higher the rate of iatrogenic anemia (p-value < 0.001). We concluded that there was a statistical significance in the production of iatrogenic anemia due to the daily sampling for laboratory monitoring and critical procedures in intensive care units. The implementation of patient blood management programs could address these issues.

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PBM: Now more than ever necessary

Cited by 3 publications

References 17 publications

A Cohort Study in Intensive Care Units: Health Decisions Related to Blood Transfusion during the COVID-19 Pandemic

A Cohort Study in Intensive Care Units: Health Decisions Related to Blood Transfusion during the COVID-19 Pandemic

Enhanced recovery after surgery: a narrative review on patient blood management recommendations

Related Factors of Anemia in Critically Ill Patients: A Prospective Multicenter Study

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