患者血液管理:阜外医院单中心证据和实践

Patient Blood Management:Single Center Evidence and Practice at Fuwai Hospital

失血和输血是心血管外科及心血管麻醉的重要质控指标。患者血液管理(patient blood management,PBM)指基于循证医学证据对可能接受输血治疗的患者开展的包括贫血干预、血液稀释、血液回收、凝血管理等在内的多学科协作诊疗,以期尽可能减少血制品输注和改善患者预后。心血管外科开展PBM需心脏外科医生、血管外科医生、麻醉科医生、体外循环科医生、危重症科医生和其他医务工作者的团队合作。本文着重介绍了阜外医院PBM的证据和实践。临床在开展PBM时,需考虑机构的资源情况,包括设备、技术、药品、技能的可获得性以及花费效益比。

Blood loss and blood transfusion requirement are important quality control indicators of cardiovascular surgery and cardiovascular anesthesia.Patient blood management(PBM)is an evidence-based,multidisciplinary approach to optimizing the care of patients who may need transfusion,which encompasses anemia management,hemodilution,cell salvage,hemostatic treatment,and other approaches to reducing bleeding and minimizing blood transfusion.PBM in cardiovascular surgery is a"team sport"that involves cardiac and vascular surgeons,anesthesiologists,perfusionist,intensivists,and other health care providers.The current work provides an overview of evidence and practice of PBM at Fuwai Hospital.Implementation of PBM should also take local resource availability and costeffectiveness of different devices,drugs,technologies,and techniques into consideration.