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Getting patient blood management Pillar 1 right in the Asia-Pacific: a call for action

Authors
Abdullah, Hairil RizalAng, Ai LeenFroessler, BerndHofmann, AxelJang, Jun HoKim, Young WooLasocki, SigismondLee, Jeong JaeLee, Shir YingLim, Kar Koong CarolSingh, GurpalSpahn, Donat R.Um, Tae Hyun
Issue Date
Jun-2020
Publisher
Singapore Medical Association
Keywords
anaemia; Asia Pacific; iron deficiency; patient blood management; preoperative
Citation
Singapore Medical Journal, v.61, no.6, pp 287 - 296
Pages
10
Journal Title
Singapore Medical Journal
Volume
61
Number
6
Start Page
287
End Page
296
URI
https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/19515
DOI
10.11622/smedj.2019037
ISSN
0037-5675
Abstract
Preoperative anaemia is common in the Asia-Pacific. Iron deficiency anaemia (IDA) is a risk factor that can be addressed under patient blood management (PBM) Pillar 1, leading to reduced morbidity and mortality. We examined PBM implementation under four different healthcare systems, identified challenges and proposed several measures: (a) Test for anaemia once patients are scheduled for surgery. (b) Inform patients about risks of preoperative anaemia and benefits of treatment. (c) Treat IDA and replenish iron stores before surgery, using intravenous iron when oral treatment is ineffective, not tolerated or when rapid iron replenishment is needed; transfusion should not be the default management. (d) Harness support from multiple medical disciplines and relevant bodies to promote PBM implementation. (e) Demonstrate better outcomes and cost savings from reduced mortality and morbidity. Although PBM implementation may seem complex and daunting, it is feasible to start small. Implementing PBM Pillar 1, particularly in preoperative patients, is a sensible first step regardless of the healthcare setting.
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