As the largest professional group involved in direct clinical care, nurses have a vital role to play in venous thromboembolism prevention. This article describes the condition and its implications for patients. It discusses how nurses can reduce the risk of harm to patients through risk assessment and thromboprophylaxis, and by educating patients.
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ESAs in perioperative anemia management: Who, what, how and why?
Best Pract Res Clin Anaesthesiol
December 2023
Université d'Angers, Département Anesthésie Réanimation, CHU Angers, Angers, France; Université d'Angers, UMR CNRS 6015, Inserm U1083, Unité MitoVasc, Team Carme, Angers, France.
Preoperative anemia is frequent and is associated with poor patient outcomes and higher transfusion rates. Perioperative blood transfusion is also associated with poor outcomes. These observations justify efforts to increase hemoglobin levels in anemic patients before surgeries with a moderate to high bleeding risk.
View Article and Find Full Text PDFDoes patient blood management represent good value for money?
Best Pract Res Clin Anaesthesiol
December 2023
Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Australia; Department of Clinical Haematology, Monash Health, Melbourne, Australia. Electronic address:
Patient blood management is the umbrella term for a suite of initiatives designed to optimise blood product usage, minimise transfusion needs, and ensure appropriate and evidence-based transfusion practices. In this review we summarise published economic evaluations of patient blood management to determine whether they represent good value for money. We identified 54 economic evaluations of patient blood management, the majority of which had positive cost-effectiveness conclusions.
View Article and Find Full Text PDFDoes one unit really matter? Immunological effects of transfusion after universal leucodepletion.
Best Pract Res Clin Anaesthesiol
December 2023
Department of Anesthesiology and Perioperative Medicine, The University of Texas, MD Anderson Cancer Center, USA; Anesthesiology and Surgical Oncology Research Group, USA. Electronic address:
Patients with cancer who receive allogeneic red blood cell transfusions are at risk of adverse reactions of varying severity. One of these reactions is immunomodulation, also known as transfusion-related immunomodulation. With the exact mechanism of transfusion related immunomodulation being unclear, storage lesions (both the cellular and cytokine component) are considered a major contributor.
View Article and Find Full Text PDFPostoperative anaemia: Hiding in plain sight.
Best Pract Res Clin Anaesthesiol
December 2023
Department of Anesthesiology & Perioperative Medicine, Mayo Clinic, Minnesota, 200 1st St SW, Rochester, MN, 55906, USA. Electronic address:
Postoperative anaemia is common among surgical patients. While often viewed as a benign condition, postoperative anaemia is neither inevitable nor harmless, being intricately linked with adverse outcomes. In this review, we summarize the prevalence, aetiology, and outcomes of postoperative anaemia and highlight prevention and management strategies.
View Article and Find Full Text PDFHow low can you go: Restrictive transfusion strategies in major surgery and physiological triggers.
Best Pract Res Clin Anaesthesiol
December 2023
Department of Anesthesia, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada; Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Physiology, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada. Electronic address:
Anemia and red blood cell transfusion are associated with adverse outcomes. Large randomized trials have demonstrated that restrictive transfusion strategies can safely reduce patient exposure to transfusion, forming a foundational pillar of patient blood management. The restrictive transfusion thresholds in these trials ranged from 7 to 8 g/dL for different populations and this variability is reflected in recent guideline recommendations for transfusion triggers.
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