Evaluation of clinical practice in perioperative patient blood management

Several guidelines have been published to facilitate implementation of patient blood management (PBM). This study was performed to evaluate clinical practices in PBM. An online survey based on the guidelines for the management of severe perioperative bleeding from the European Society of Anaesthesio...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:British journal of anaesthesia : BJA 2016-11, Vol.117 (5), p.610-616
Hauptverfasser: Baron, D.M., Metnitz, P.G.H., Fellinger, T., Metnitz, B., Rhodes, A., Kozek-Langenecker, S.A.
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 616
container_issue 5
container_start_page 610
container_title British journal of anaesthesia : BJA
container_volume 117
creator Baron, D.M.
Metnitz, P.G.H.
Fellinger, T.
Metnitz, B.
Rhodes, A.
Kozek-Langenecker, S.A.
description Several guidelines have been published to facilitate implementation of patient blood management (PBM). This study was performed to evaluate clinical practices in PBM. An online survey based on the guidelines for the management of severe perioperative bleeding from the European Society of Anaesthesiology (ESA) was conducted among ESA members. We assessed characteristic data of participating physicians, preoperative assessment of bleeding risk and anaemia, intraoperative transfusion practices, specific pharmacologic treatment of significant bleeding, and clinical use of PBM algorithms. Data distributions for five European regions and the workplace and experience of physicians were analysed using a χ2 test. We received 706 fully completed surveys from physicians in 57 countries. Most (99%) respondents were anaesthetists or intensive care physicians, and 68% worked at university or university-affiliated hospitals. A standardised bleeding history before surgery is routinely obtained by 48% of physicians. When bleeding history is negative, 55% of physicians routinely order preoperative coagulation testing. Only 24% of physicians timely assess patients at risk of bleeding during surgery for anaemia before elective surgery. When anaemia is diagnosed, 38% of physicians routinely investigate its cause. The rate of routinely performed targeted haemostatic interventions with fibrinogen, vitamin K or prothrombin complex, and tranexamic acid was 60%, 52%, and 54%, respectively. Algorithms to guide PBM are used by 62% of physicians. Results varied between geographic regions. Major deficits exist in the use of recommended PBM among anaesthetists, indicating an opportunity to improve clinical standards.
doi_str_mv 10.1093/bja/aew308
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1835001241</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/bja/aew308</oup_id><els_id>S0007091217300193</els_id><sourcerecordid>1835001241</sourcerecordid><originalsourceid>FETCH-LOGICAL-c398t-23fd252210f73c08f7c893f088138144f034854dc49cb4e8581596fe53eea1873</originalsourceid><addsrcrecordid>eNp9kEFLwzAUx4Mobk4vfgDpRRChLmnSJTnKmDoYeNFzyNIXyWibmrQTv72RTk_i5f3h8Xt_eD-ELgm-I1jS-Xan5xo-KBZHaEoYJ_mCc3KMphhjnmNJigk6i3GHMeGFLE_RpOBcSsLLKVqv9roedO98m3mbmdq1zug664I2vTOQuTbrIDifRqL2kHUpoO2zbe19lTW61W_QpMU5OrG6jnBxyBl6fVi9LJ_yzfPjenm_yQ2Vos8LaquiLAqCLacGC8uNkNRiIQgVhDGLKRMlqwyTZstAlIKUcmGhpACaCE5n6Gbs7YJ_HyD2qnHRQF3rFvwQFRG0TJ8WjCT0dkRN8DEGsKoLrtHhUxGsvtWppE6N6hJ8degdtg1Uv-iPqwRcj4Afuv-L2MhBsrB3EFQ0yZiBygUwvaq8--vsCyU4iLw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1835001241</pqid></control><display><type>article</type><title>Evaluation of clinical practice in perioperative patient blood management</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Baron, D.M. ; Metnitz, P.G.H. ; Fellinger, T. ; Metnitz, B. ; Rhodes, A. ; Kozek-Langenecker, S.A.</creator><creatorcontrib>Baron, D.M. ; Metnitz, P.G.H. ; Fellinger, T. ; Metnitz, B. ; Rhodes, A. ; Kozek-Langenecker, S.A.</creatorcontrib><description>Several guidelines have been published to facilitate implementation of patient blood management (PBM). This study was performed to evaluate clinical practices in PBM. An online survey based on the guidelines for the management of severe perioperative bleeding from the European Society of Anaesthesiology (ESA) was conducted among ESA members. We assessed characteristic data of participating physicians, preoperative assessment of bleeding risk and anaemia, intraoperative transfusion practices, specific pharmacologic treatment of significant bleeding, and clinical use of PBM algorithms. Data distributions for five European regions and the workplace and experience of physicians were analysed using a χ2 test. We received 706 fully completed surveys from physicians in 57 countries. Most (99%) respondents were anaesthetists or intensive care physicians, and 68% worked at university or university-affiliated hospitals. A standardised bleeding history before surgery is routinely obtained by 48% of physicians. When bleeding history is negative, 55% of physicians routinely order preoperative coagulation testing. Only 24% of physicians timely assess patients at risk of bleeding during surgery for anaemia before elective surgery. When anaemia is diagnosed, 38% of physicians routinely investigate its cause. The rate of routinely performed targeted haemostatic interventions with fibrinogen, vitamin K or prothrombin complex, and tranexamic acid was 60%, 52%, and 54%, respectively. Algorithms to guide PBM are used by 62% of physicians. Results varied between geographic regions. Major deficits exist in the use of recommended PBM among anaesthetists, indicating an opportunity to improve clinical standards.</description><identifier>ISSN: 0007-0912</identifier><identifier>EISSN: 1471-6771</identifier><identifier>DOI: 10.1093/bja/aew308</identifier><identifier>PMID: 27799175</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Blood Loss, Surgical - prevention &amp; control ; Blood Transfusion - statistics &amp; numerical data ; coagulation ; Europe ; Health Care Surveys - statistics &amp; numerical data ; Hemostasis ; Hemostatics - therapeutic use ; Humans ; patient blood management ; Perioperative Care - methods ; perioperative period ; Practice Patterns, Physicians' - statistics &amp; numerical data ; surgery ; transfusion</subject><ispartof>British journal of anaesthesia : BJA, 2016-11, Vol.117 (5), p.610-616</ispartof><rights>2016 The Author(s)</rights><rights>The Author 2016. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com 2016</rights><rights>The Author 2016. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c398t-23fd252210f73c08f7c893f088138144f034854dc49cb4e8581596fe53eea1873</citedby><cites>FETCH-LOGICAL-c398t-23fd252210f73c08f7c893f088138144f034854dc49cb4e8581596fe53eea1873</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27799175$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Baron, D.M.</creatorcontrib><creatorcontrib>Metnitz, P.G.H.</creatorcontrib><creatorcontrib>Fellinger, T.</creatorcontrib><creatorcontrib>Metnitz, B.</creatorcontrib><creatorcontrib>Rhodes, A.</creatorcontrib><creatorcontrib>Kozek-Langenecker, S.A.</creatorcontrib><title>Evaluation of clinical practice in perioperative patient blood management</title><title>British journal of anaesthesia : BJA</title><addtitle>Br J Anaesth</addtitle><description>Several guidelines have been published to facilitate implementation of patient blood management (PBM). This study was performed to evaluate clinical practices in PBM. An online survey based on the guidelines for the management of severe perioperative bleeding from the European Society of Anaesthesiology (ESA) was conducted among ESA members. We assessed characteristic data of participating physicians, preoperative assessment of bleeding risk and anaemia, intraoperative transfusion practices, specific pharmacologic treatment of significant bleeding, and clinical use of PBM algorithms. Data distributions for five European regions and the workplace and experience of physicians were analysed using a χ2 test. We received 706 fully completed surveys from physicians in 57 countries. Most (99%) respondents were anaesthetists or intensive care physicians, and 68% worked at university or university-affiliated hospitals. A standardised bleeding history before surgery is routinely obtained by 48% of physicians. When bleeding history is negative, 55% of physicians routinely order preoperative coagulation testing. Only 24% of physicians timely assess patients at risk of bleeding during surgery for anaemia before elective surgery. When anaemia is diagnosed, 38% of physicians routinely investigate its cause. The rate of routinely performed targeted haemostatic interventions with fibrinogen, vitamin K or prothrombin complex, and tranexamic acid was 60%, 52%, and 54%, respectively. Algorithms to guide PBM are used by 62% of physicians. Results varied between geographic regions. Major deficits exist in the use of recommended PBM among anaesthetists, indicating an opportunity to improve clinical standards.</description><subject>Blood Loss, Surgical - prevention &amp; control</subject><subject>Blood Transfusion - statistics &amp; numerical data</subject><subject>coagulation</subject><subject>Europe</subject><subject>Health Care Surveys - statistics &amp; numerical data</subject><subject>Hemostasis</subject><subject>Hemostatics - therapeutic use</subject><subject>Humans</subject><subject>patient blood management</subject><subject>Perioperative Care - methods</subject><subject>perioperative period</subject><subject>Practice Patterns, Physicians' - statistics &amp; numerical data</subject><subject>surgery</subject><subject>transfusion</subject><issn>0007-0912</issn><issn>1471-6771</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEFLwzAUx4Mobk4vfgDpRRChLmnSJTnKmDoYeNFzyNIXyWibmrQTv72RTk_i5f3h8Xt_eD-ELgm-I1jS-Xan5xo-KBZHaEoYJ_mCc3KMphhjnmNJigk6i3GHMeGFLE_RpOBcSsLLKVqv9roedO98m3mbmdq1zug664I2vTOQuTbrIDifRqL2kHUpoO2zbe19lTW61W_QpMU5OrG6jnBxyBl6fVi9LJ_yzfPjenm_yQ2Vos8LaquiLAqCLacGC8uNkNRiIQgVhDGLKRMlqwyTZstAlIKUcmGhpACaCE5n6Gbs7YJ_HyD2qnHRQF3rFvwQFRG0TJ8WjCT0dkRN8DEGsKoLrtHhUxGsvtWppE6N6hJ8degdtg1Uv-iPqwRcj4Afuv-L2MhBsrB3EFQ0yZiBygUwvaq8--vsCyU4iLw</recordid><startdate>201611</startdate><enddate>201611</enddate><creator>Baron, D.M.</creator><creator>Metnitz, P.G.H.</creator><creator>Fellinger, T.</creator><creator>Metnitz, B.</creator><creator>Rhodes, A.</creator><creator>Kozek-Langenecker, S.A.</creator><general>Elsevier Ltd</general><general>Oxford University Press</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201611</creationdate><title>Evaluation of clinical practice in perioperative patient blood management</title><author>Baron, D.M. ; Metnitz, P.G.H. ; Fellinger, T. ; Metnitz, B. ; Rhodes, A. ; Kozek-Langenecker, S.A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c398t-23fd252210f73c08f7c893f088138144f034854dc49cb4e8581596fe53eea1873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Blood Loss, Surgical - prevention &amp; control</topic><topic>Blood Transfusion - statistics &amp; numerical data</topic><topic>coagulation</topic><topic>Europe</topic><topic>Health Care Surveys - statistics &amp; numerical data</topic><topic>Hemostasis</topic><topic>Hemostatics - therapeutic use</topic><topic>Humans</topic><topic>patient blood management</topic><topic>Perioperative Care - methods</topic><topic>perioperative period</topic><topic>Practice Patterns, Physicians' - statistics &amp; numerical data</topic><topic>surgery</topic><topic>transfusion</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Baron, D.M.</creatorcontrib><creatorcontrib>Metnitz, P.G.H.</creatorcontrib><creatorcontrib>Fellinger, T.</creatorcontrib><creatorcontrib>Metnitz, B.</creatorcontrib><creatorcontrib>Rhodes, A.</creatorcontrib><creatorcontrib>Kozek-Langenecker, S.A.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of anaesthesia : BJA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Baron, D.M.</au><au>Metnitz, P.G.H.</au><au>Fellinger, T.</au><au>Metnitz, B.</au><au>Rhodes, A.</au><au>Kozek-Langenecker, S.A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluation of clinical practice in perioperative patient blood management</atitle><jtitle>British journal of anaesthesia : BJA</jtitle><addtitle>Br J Anaesth</addtitle><date>2016-11</date><risdate>2016</risdate><volume>117</volume><issue>5</issue><spage>610</spage><epage>616</epage><pages>610-616</pages><issn>0007-0912</issn><eissn>1471-6771</eissn><abstract>Several guidelines have been published to facilitate implementation of patient blood management (PBM). This study was performed to evaluate clinical practices in PBM. An online survey based on the guidelines for the management of severe perioperative bleeding from the European Society of Anaesthesiology (ESA) was conducted among ESA members. We assessed characteristic data of participating physicians, preoperative assessment of bleeding risk and anaemia, intraoperative transfusion practices, specific pharmacologic treatment of significant bleeding, and clinical use of PBM algorithms. Data distributions for five European regions and the workplace and experience of physicians were analysed using a χ2 test. We received 706 fully completed surveys from physicians in 57 countries. Most (99%) respondents were anaesthetists or intensive care physicians, and 68% worked at university or university-affiliated hospitals. A standardised bleeding history before surgery is routinely obtained by 48% of physicians. When bleeding history is negative, 55% of physicians routinely order preoperative coagulation testing. Only 24% of physicians timely assess patients at risk of bleeding during surgery for anaemia before elective surgery. When anaemia is diagnosed, 38% of physicians routinely investigate its cause. The rate of routinely performed targeted haemostatic interventions with fibrinogen, vitamin K or prothrombin complex, and tranexamic acid was 60%, 52%, and 54%, respectively. Algorithms to guide PBM are used by 62% of physicians. Results varied between geographic regions. Major deficits exist in the use of recommended PBM among anaesthetists, indicating an opportunity to improve clinical standards.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>27799175</pmid><doi>10.1093/bja/aew308</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0007-0912
ispartof British journal of anaesthesia : BJA, 2016-11, Vol.117 (5), p.610-616
issn 0007-0912
1471-6771
language eng
recordid cdi_proquest_miscellaneous_1835001241
source MEDLINE; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection
subjects Blood Loss, Surgical - prevention & control
Blood Transfusion - statistics & numerical data
coagulation
Europe
Health Care Surveys - statistics & numerical data
Hemostasis
Hemostatics - therapeutic use
Humans
patient blood management
Perioperative Care - methods
perioperative period
Practice Patterns, Physicians' - statistics & numerical data
surgery
transfusion
title Evaluation of clinical practice in perioperative patient blood management
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T20%3A23%3A01IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Evaluation%20of%20clinical%20practice%20in%20perioperative%20patient%20blood%20management&rft.jtitle=British%20journal%20of%20anaesthesia%20:%20BJA&rft.au=Baron,%20D.M.&rft.date=2016-11&rft.volume=117&rft.issue=5&rft.spage=610&rft.epage=616&rft.pages=610-616&rft.issn=0007-0912&rft.eissn=1471-6771&rft_id=info:doi/10.1093/bja/aew308&rft_dat=%3Cproquest_cross%3E1835001241%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1835001241&rft_id=info:pmid/27799175&rft_oup_id=10.1093/bja/aew308&rft_els_id=S0007091217300193&rfr_iscdi=true