NEWS RELEASE
[FOR IMMEDIATE RELEASE]
Friday, September 7, 2007
Contact: Robert J. Kochinski, SABM Executive Director
Tel: (414) 276-9339
Fax: (414) 276-3349
E-mail: rkopchinski@sabm.org
Website: www.sabm.org
Why is Blood Management/Conservation Necessary?
LOS ANGELES (date) – "Blood management" encompasses a full spectrum of techniques designed to avoid allogeneic (another person’s stored) blood transfusion. While there is a place in the practice of medicine for allogenic transfusion, practitioners have honed conservative management techniques through treating patients who choose either for religious reasons or personal preference to decline blood transfusion altogether.
Reasons why judicious blood management is critical in today’s healthcare environment include:
- Cost: It is estimated that every unit of red blood cells that are transfused, increase hospital costs by a non-reimbursable $1000-$1300/unit.
- Better patient outcomes: Allogeneic transfusion increases postoperative infection rates, decreases survival for patients undergoing cancer surgery, and potentially exposes the patient to a wide variety of infectious disease. (A comprehensive review of the outcome impact on patients by Aryeh Shander, MD, can be found in the journal, Seminars in Hematology.¹ )
- Pervasive gaps in the demand for banked blood and its available supply.
How is the blood management approach different?
- Careful attention is paid to attaining and keeping normal hematocrit via reduced blood draws for testing and the use of blood-building medications.
- Preoperative anemia has been documented to range from 5% in female geriatric hip fracture patients to over 75% in colon cancer patients.² Patients that are anemic entering the operating room tend to get more transfusions.
- During surgery numerous devices / techniques can be used to reduce blood loss. When all of these therapies are combined, patients can tolerate huge blood losses and not need allogeneic transfusion. (a full discussion of these techniques is found in the journal, Transfusion.³)
- These include:
- Specialized cutting devices that also seal blood vessels.
- Cell Salvage - Blood that is lost during surgery can be collected, filtered, washed and given right back to the patient.
- Normovolemic hemodilution - involves removing blood prior to the start of surgery. Blood is placed in storage bags so that blood lost during surgery is much less concentrated. The removed blood is then returned to the patient at the end of surgery.
- Drug therapy - a number of drugs exist which can enhance clot formation or decrease normal blood clot breakdown.
1 Shander A.: Emerging Risks and Outcomes of Blood Transfusion in Surgery. Seminars in Hematology. 41(1 Suppl 1):117-24, 2004
2 Shander A., Knight K., Thurer R., Adamson J., Spence R.: Prevalence and Outcomes of Anemia in Surgery: A Systematic Review of the Literature. American Journal of Medicine. 2004;116 Suppl 7A:58S-69S
3 Goodnough LT., Shander A., Spence R.: Bloodless Medicine: Clinical Care Without Allogeneic Blood Transfusion. Transfusion. 43(5):668-76, 2003 May.
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