31 March 2019 (Sunday) - Best Practice ?

Here’s something which appeared on one of the work-related Facebook groups I follow. I must admit I copied out the link and forgot which group it came from.

Questions  What is the current evidence base for patient blood management (PBM) in adults, and what international clinical recommendations can be derived for preoperative anemia, red blood cell transfusion thresholds, and PBM implementation strategies?

Findings  Diagnosis and management of preoperative anemia is crucial, and iron-deficient anemia should be treated with iron supplementation. Red blood cell transfusion thresholds for critically ill, clinically stable patients (hemoglobin concentration <7 g/dL), patients undergoing cardiac surgery (hemoglobin concentration <7.5 g/dL), patients with hip fractures and cardiovascular disease or risk factors (hemoglobin concentration <8 g/dL), and hemodynamically stable patients with acute gastrointestinal bleeding (hemoglobin concentration 7-8 g/dL) are relatively well defined, although the quality of evidence is moderate to low.

Meaning  Further high-quality research to support PBM is required for a range of clinical scenarios and implementation of PBM programs.

One of the things I find very difficult about blood transfusion science is  that what is considered to be “best practice” seems to change very regularly…