The method that reduces the need for blood units
The discussion of the shortage of blood in Israel is already in the public discourse – especially since the Corona, but apart from calling on the public to donate blood, is there anything else to do? Familiarize yourself with the method that significantly reduces the need for blood units. In the world it is called “Patient blood management” Or in short BPM, and in Israel it is called “patient blood management”.The method includes:

  • Assessment of the patient’s condition before surgery to examine iron deficiency anemia (exists in about 30% of the population)
  • Treatment of anemia by giving iron to patients before elective surgery
  • Avoidance or decrease in the number of doses of blood the patient will receive in case his hemoglobin level decreases as a result of bleeding during or after the operation

This week, the Israeli-American physician Prof. Arieh Shender, who developed the method and was recognized by Time magazine as one of the “heroes of medicine” in America, landed in Israel to lecture at groups of gynecologists, internists and orthopedists at the Galilee Medical Center in Nahariya. As part of the treatment, he conducted a “Patient Blood Management” workshop on the importance of clarifying iron deficiency anemia before surgery and the need to reduce the amount of blood doses given to patients.

According to the treatment method, it is possible to save huge amounts of blood units per patient, shorten hospitalization time and save many millions for hospitals (which will also answer the budgetary distress of the health system). Until recently, Dr. Bershter, the hematologist and director of the blood bank, together with the director of the Galilee Medical Center, Prof. Barhum, conducted a study for 5 years, in which they succeeded in reducing blood counts for patients by 30%. So this experiment proved itself and Professor Shender calls for the application of the method in all hospitals in Israel, a method that exists in many places in the world and is supported by the World Health Organization.

 

Of course in life-threatening cases there is no escape from using blood doses but they say the hand is very “light on the trigger” when asking for hospital blood doses for patients. Each case must be considered on its own merits and the need and necessity of this treatment examined.

Why is it important to treat anemia before having surgery?

Patients with anemia, who are referred for a surgical procedure with a high risk of bleeding, are at increased risk for morbidity and mortality after surgery. In 2010, the World Health Organization (WHO) recommended the implementation of the Patient Blood Management (PBM) program. The program is based on a multidisciplinary approach designed to streamline treatment for patients who may need a blood transfusion. This program focuses on the patient himself as opposed to the standard program that focuses on blood products. It has been known for many years that blood transfusions, despite being life-saving in some cases, are also considered a risk factor for illness, prolonged hospitalization and even mortality. The program encompasses all aspects of the decision-making process in transfusion, from the initial assessment of the patient to clinical management. The goals of the program include:

  • Improving treatment by evaluating and treating preoperative anemia, evaluating and treating coagulation disorders, avoiding unnecessary blood transfusions, thereby reducing infectious and non-infectious complications associated with transfusion.
  • Providing blood products to patients required for this.
  • Reducing hospitalization costs.

The program is now considered a safety and quality standard for the care of patients. Many studies show that applying the PBM principles throughout the preoperative period may reduce mortality, morbidity, blood transfusions, length of hospital stay, costs and better utilization of medical resources while maintaining patient safety. The economic significance stems from the fact that red blood cell transfusion is significantly associated with an increased stay in the intensive care unit and complications acquired at the hospital. These negative results have a significant financial impact on hospital budgets.

By Editor

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