1.Getting patient blood management Pillar 1 right in the Asia-Pacific: a call for action.
Hairil Rizal ABDULLAH ; Ai Leen ANG ; Bernd FROESSLER ; Axel HOFMANN ; Jun Ho JANG ; Young Woo KIM ; Sigismond LASOCKI ; Jeong Jae LEE ; Shir Ying LEE ; Kar Koong Carol LIM ; Gurpal SINGH ; Donat R SPAHN ; Tae Hyun UM
Singapore medical journal 2020;61(6):287-296
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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