1 - Interno de Imunohemoterapia, Centro Hospitalar de Lisboa Central
2 - Assistente Hospitalar, Imunohemoterapia, Hospital Curry Cabral, Centro Hospitalar de Lisboa Central
3 - Assistente Hospitalar, Anestesiologia,Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central
4 - Chefe de Serviço, Imunohemoterapia, Centro Hospitalar de Lisboa Central
- The 19th Annual NATA Symposium on Patient Blood Management, Haemostasis and Thrombosis, April 12 – 13, Lisboa.
Resumo:
Introduction:
Patient Blood Management (PBM) programs have been introduced during the last 10 years to minimize the use of blood transfusion. Pediatrics scoliosis surgery (PSS) is associated with high rates of packed red blood cells (RBC) transfusion. At Hospital Dona Estefânia, between 2013-2015, there was a median consumption of 2 RBCs per scoliosis surgery. In January 2016, a PBM program was adopted at our institution. The aim of this work is to evaluate the efficiency of our PBM program.
Methods:
The PBM program was introduced by a multidisciplinary team since January 2016. It included a restrictive transfusion strategy (Transfuse only if Hb<7g/dL) and other specific elements (Screening for anemia and/or ferropenia - Optimization of Hb; Infusion of tranexamic acid in all patients; Therapy and/or prophylaxis of haemorrhagic diatheses: Use of desmopressin (DDAVP); fibrinogen concentrates (Fib.) or other procoagulant drugs). Retrospective data evaluation allowed us to compare the patients submitted to scoliosis surgery before (2013-2015, n=59) and after (2016-2017, n=52) the implementation of the PBM.
Conclusions:
- The median of packed RBCs consumed in the perioperative period decreased from two (2013-2015) to zero (2016-2017);
- The length of stay at PICU followed the same pattern, prior to PBM the patients had a median stay of 3 days at PICU, after PBM implementation they only spend 1,85 days at the unit;
- The implementation of the PBM program allowed for a substantial decrease of packed RBC transfusion and length of PICU admission.
Palavras Chave: PBM - Scoliosis Surgery