Transfusion practice for surgical patients has changed from replacing surgically lost blood with allogeneic blood transfusions to implementing strategies that reduce transfusion requirements. Patient Blood Management (PBM), which is "the timely application of evidence-based medical and surgical concepts designed to maintain haemoglobin concentration, optimize hemostasis and minimize blood loss in an effort to improve patient outcome. There is mounting evidence that multimodal patient blood management (PBM) programmes can be effective at improving postoperative outcomes and reducing perioperative blood transfusions and costs The Turkish Society of Anaesthesiologists PBM Task Force has been working on this subject and studied transfusion practice throughout all through the peri-operative periods. Unfortunately we documented a high transfusion rate in major surgical patients in Turkey. One of the surgeries, that has high transfusion rate, was orthopaedic surgery. According to our recent data we planned to implement PBM in major orthopaedic surgical patients and evaluate the effects PBM in transfusion rate and patient outcomes. While some elements of PBM have a strong evidence base in hip or knee replacement, such as the use of tranexamic acid (TXA) the evidence for preoperative anaemia optimisation with iron is less robust. Implementing PBM all through the operative period gains more importance.
Active PBM Implementation: Patients undergoing hip or knee arthroplasty will be treated as follows: PBM will be performed as shown in the graph below "PBM Implementation Group".
Active PBM group will be treated for preoperative anemia at least 3 weeks prior to the surgical intervention as per the "Anemia Algorithm" below Other pillars of PBM will be also performed to the treatment group as per the visual graph below. The parameters included in the PBM pillars will be recorded including preoperative anemia parameters. Postoperative variables and parameters related to complications will be recorded.
For the control group (Non-PBM group), the data of the patients, will be prospectively included.
The 1:1 ratio of the control and active groups will be done.
| Condition | Arthropathy |
|---|---|
| Treatment | patient blood management |
| Clinical Study Identifier | NCT05319223 |
| Sponsor | Prof. Serdar Gunaydin |
| Last Modified on | 3 February 2023 |
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