Research Article
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Evaluation of the relationship between patient blood management and anesthesia method in cesarean section: A single-center study

Year 2024, Volume: 2 Issue: 2, 69 - 73, 29.05.2024
https://doi.org/10.61678/bursamed.1465508

Abstract

Objectives: Patient blood management (PBM) aims to improve patient outcome and safety by reducing the quantity of unnecessary blood transfusions and vitalizing patient-specific anemia reserves. We aimed to determine the efficiency and practicality of patient blood management in the cesarean section operating room in our hospital and the effects of the anesthesia method in cesarean section.
Methods: Between 2019 and 2021, 6011 patients who underwent cesarean section were reviewed at Bursa City Hospital. Patients who received perioperative or postoperative blood product transfusion were divided into two groups as Group I (n=614) and patients who were not transfused into Group II (n=5397). Demographic data of the patients, preoperative hemogram laboratory values, performed anesthesia methods, transfusion rate were recorded from the database.
Results: There was no statistically significant difference between the two groups in terms of demographic data (p>0.05). The preoperative anemia rate was 35.91% (n=2159) and in these patients the blood transfusion rate was 21.86% (n=472). Total transfusion rate was reported as 10.21% (n=614). Preoperative hemoglobin levels were statistically lower in Group I. The spinal anesthesia method was found to be statistically higher in both groups.
Conclusion: Patient blood management is very important. In line with the guidelines on this subject, it will reduce unnecessary transfusions and therefore the risks of transfusion complications. In addition, considering the difficulty of supplying blood products, blood transfusion should not be considered primarily as a treatment. Anemia treatment should be planned before surgery and hemoglobin levels should be optimized. It is recommended to prefer regional anesthesia for PBM at cesarean section. In this way, we think that we will both increase the efficiency of patient blood management and reduce the cost and complications of blood transfusion.

References

  • National Blood Authority.Patient Blood Management Guidelines: Module 5 Obstetrics and Maternity .Available at. https://nba.gov.au/system/files/documents/20180426-Module5-WEB.pdf
  • Muñoz M, Stensballe J, Ducloy-Bouthors AS, et al. Patient blood management in obstetrics: prevention and treatment of postpartum haemorrhage. A NATA consensus statement. Blood Transfus. 2019;17(2):112-136.
  • Schwickert A, van Beekhuizen HJ, Bertholdt C, et al. Association of peripartum management and high maternal blood loss at cesarean delivery for placenta accreta spectrum (PAS): A multinational database study. Acta Obstet Gynecol Scand. 2021;100 Suppl 1:29-40.
  • Sadana D, Pratzer A, Scher LJ, et al. Promoting High-Value Practice by Reducing Unnecessary Transfusions With a Patient Blood Management Program. JAMA Intern Med. 2018;178(1):116-122.
  • Neb H, Zacharowski K, Meybohm P. Strategies to reduce blood product utilization in obstetric practice. Curr Opin Anaesthesiol. 2017;30(3):294-299.
  • Hong JY, Jee YS, Yoon HJ, Kim SM. Comparison of general and epidural anesthesia in elective cesarean section for placenta previa totalis: maternal hemodynamics, blood loss and neonatal outcome. Int J Obstet Anesth. 2003;12(1):12-16
  • Practice Guidelines for Obstetric Anesthesia: An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology. Anesthesiology. 2016;124(2):270-300.
  • Goodnough LT, Shander A. Blood management. Arch Pathol Lab Med. 2007;131:695-701
  • Goel R, Shi PA. Patient Blood Management. In: Shaz BH, Hillyer CD, Gil MR, editors. Transfusion Medicine and Hemostasis (Third Edition). Elsevier, 2019. 371-8.
  • Yazer MH, Waters JH. How do I implement a hospital-based blood management program?. Transfusion. 2012;52(8):1640-1645.
  • World Health Organization The Global Prevalence of Anaemia in 2011. 2015. Available at: https://apps.who.int/iris/bitstream/handle/10665/177094/9789241564960_eng.pdf
  • Recommendations to Prevent and Control Iron Deficiency in the United States. [(accessed on 21 December 2022)]; Available at : https://www.cdc.gov/mmwr/preview/mmwrhtml/00051880.htm
  • American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins Obstetrics Anemia in Pregnancy: ACOG Practice Bulletin, Number 233. Obstet. Gynecol. 2021;138:e55–e64.
  • Stevens GA, Finucane MM, De-Regil LM, et al. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995-2011: a systematic analysis of population-representative data. Lancet Glob Health. 2013;1(1):e16-e25.
  • Patterson JA, Roberts CL, Bowen JR, et al. Blood transfusion during pregnancy, birth, and the postnatal period. Obstet Gynecol. 2014;123(1):126-133.
  • Muñoz M, Peña-Rosas JP, Robinson S, et al. Patient blood management in obstetrics: management of anaemia and haematinic deficiencies in pregnancy and in the post-partum period: NATA consensus statement. Transfus Med. 2018;28(1):22-39.
  • Tezcan B.Etkin Hasta Kan Yönetimi. JARSS 2019;27(3):167-173 .
  • Ilgınel MT. Anormal Plasental İnvazyonda Anestezi Yönetimi. aktd. September 2019;28(3):177-183.
  • Horlocker TT, Vandermeuelen E, Kopp SL, Gogarten W, Leffert LR, Benzon HT. Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Fourth Edition) Reg Anesth Pain Med. 2018;43(3):263-309.
  • Bollag L, Lim G, Sultan P, et al. Society for Obstetric Anesthesia and Perinatology: Consensus Statement and Recommendations for Enhanced Recovery After Cesarean. Anesth Analg. 2021;132(5):1362-1377.
  • Farmer SL, Trentino K, Hofmann A, et al. A Programmatic Approach to Patient Blood Management - Reducing Transfusions and Improving Patient outcomes. The Open Anesthesiol J. 2015;9:6-16.
  • Bernard AC,Davenport DL, Chang PK et al. Intraoperative transfusion of 1 U to 2 U packed red bloodcells is associated with increased 30-day mortality, surgical-site infection, pneumonia, and sepsis in general surgery patients. J Am Coll Surg. 2009;208:931-7.
  • Engoren M, Schwann TA, Habib RH, Neill SN, Vance JL, Likosky DS. The independent effects of anemia and transfusion on mortality after coronary artery bypass. Ann Thorac Surg. 2014;97(2):514-520.
Year 2024, Volume: 2 Issue: 2, 69 - 73, 29.05.2024
https://doi.org/10.61678/bursamed.1465508

Abstract

References

  • National Blood Authority.Patient Blood Management Guidelines: Module 5 Obstetrics and Maternity .Available at. https://nba.gov.au/system/files/documents/20180426-Module5-WEB.pdf
  • Muñoz M, Stensballe J, Ducloy-Bouthors AS, et al. Patient blood management in obstetrics: prevention and treatment of postpartum haemorrhage. A NATA consensus statement. Blood Transfus. 2019;17(2):112-136.
  • Schwickert A, van Beekhuizen HJ, Bertholdt C, et al. Association of peripartum management and high maternal blood loss at cesarean delivery for placenta accreta spectrum (PAS): A multinational database study. Acta Obstet Gynecol Scand. 2021;100 Suppl 1:29-40.
  • Sadana D, Pratzer A, Scher LJ, et al. Promoting High-Value Practice by Reducing Unnecessary Transfusions With a Patient Blood Management Program. JAMA Intern Med. 2018;178(1):116-122.
  • Neb H, Zacharowski K, Meybohm P. Strategies to reduce blood product utilization in obstetric practice. Curr Opin Anaesthesiol. 2017;30(3):294-299.
  • Hong JY, Jee YS, Yoon HJ, Kim SM. Comparison of general and epidural anesthesia in elective cesarean section for placenta previa totalis: maternal hemodynamics, blood loss and neonatal outcome. Int J Obstet Anesth. 2003;12(1):12-16
  • Practice Guidelines for Obstetric Anesthesia: An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology. Anesthesiology. 2016;124(2):270-300.
  • Goodnough LT, Shander A. Blood management. Arch Pathol Lab Med. 2007;131:695-701
  • Goel R, Shi PA. Patient Blood Management. In: Shaz BH, Hillyer CD, Gil MR, editors. Transfusion Medicine and Hemostasis (Third Edition). Elsevier, 2019. 371-8.
  • Yazer MH, Waters JH. How do I implement a hospital-based blood management program?. Transfusion. 2012;52(8):1640-1645.
  • World Health Organization The Global Prevalence of Anaemia in 2011. 2015. Available at: https://apps.who.int/iris/bitstream/handle/10665/177094/9789241564960_eng.pdf
  • Recommendations to Prevent and Control Iron Deficiency in the United States. [(accessed on 21 December 2022)]; Available at : https://www.cdc.gov/mmwr/preview/mmwrhtml/00051880.htm
  • American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins Obstetrics Anemia in Pregnancy: ACOG Practice Bulletin, Number 233. Obstet. Gynecol. 2021;138:e55–e64.
  • Stevens GA, Finucane MM, De-Regil LM, et al. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995-2011: a systematic analysis of population-representative data. Lancet Glob Health. 2013;1(1):e16-e25.
  • Patterson JA, Roberts CL, Bowen JR, et al. Blood transfusion during pregnancy, birth, and the postnatal period. Obstet Gynecol. 2014;123(1):126-133.
  • Muñoz M, Peña-Rosas JP, Robinson S, et al. Patient blood management in obstetrics: management of anaemia and haematinic deficiencies in pregnancy and in the post-partum period: NATA consensus statement. Transfus Med. 2018;28(1):22-39.
  • Tezcan B.Etkin Hasta Kan Yönetimi. JARSS 2019;27(3):167-173 .
  • Ilgınel MT. Anormal Plasental İnvazyonda Anestezi Yönetimi. aktd. September 2019;28(3):177-183.
  • Horlocker TT, Vandermeuelen E, Kopp SL, Gogarten W, Leffert LR, Benzon HT. Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Fourth Edition) Reg Anesth Pain Med. 2018;43(3):263-309.
  • Bollag L, Lim G, Sultan P, et al. Society for Obstetric Anesthesia and Perinatology: Consensus Statement and Recommendations for Enhanced Recovery After Cesarean. Anesth Analg. 2021;132(5):1362-1377.
  • Farmer SL, Trentino K, Hofmann A, et al. A Programmatic Approach to Patient Blood Management - Reducing Transfusions and Improving Patient outcomes. The Open Anesthesiol J. 2015;9:6-16.
  • Bernard AC,Davenport DL, Chang PK et al. Intraoperative transfusion of 1 U to 2 U packed red bloodcells is associated with increased 30-day mortality, surgical-site infection, pneumonia, and sepsis in general surgery patients. J Am Coll Surg. 2009;208:931-7.
  • Engoren M, Schwann TA, Habib RH, Neill SN, Vance JL, Likosky DS. The independent effects of anemia and transfusion on mortality after coronary artery bypass. Ann Thorac Surg. 2014;97(2):514-520.
There are 23 citations in total.

Details

Primary Language English
Subjects Anaesthesiology
Journal Section Research Articles
Authors

Serra Topal 0000-0003-3431-0472

Publication Date May 29, 2024
Submission Date April 12, 2024
Acceptance Date May 2, 2024
Published in Issue Year 2024 Volume: 2 Issue: 2

Cite

EndNote Topal S (May 1, 2024) Evaluation of the relationship between patient blood management and anesthesia method in cesarean section: A single-center study. Journal of Bursa Faculty of Medicine 2 2 69–73.

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