Patient Blood Management: Advances and Perspectives

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Hematology".

Deadline for manuscript submissions: closed (15 January 2024) | Viewed by 2811

Special Issue Editors


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Guest Editor
Legal Medicine, University of Padua, 35121 Padua, Italy
Interests: public health education; legal medicine; medico-legal autospy; clinical risk management; damage; legal liability; medicolegal implications; ethics; patient blood management

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Guest Editor
Department of Neuroscience, University of Padua, 35121 Padua, Italy
Interests: transfusion medicine; patient blood management; legal medicine; medico-legal autopsy; clinical risk management; damage; legal liability; medicolegal; implications
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Guest Editor
National Blood Centre, Italian National Institute of Health, 00161 Rome, Italy
Interests: immunohaematology; quality systems in laboratory and clinical transfusion; haemostaseology
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
1. Transfusion Medicine Department, IRCCS San Martino Hospital, Genoa, Italy
2. Regional Blood Center, Liguria, Italy
Interests: blood transfusion; patient blood management; bleeding

Special Issue Information

Dear Colleagues,

In recent decades, increased awareness of the inherent risks of transfusion has resulted in major initiatives to mitigate those risks through improvements in blood component safety. The realisation that the intense focus on product safety had not been matched with a similar focus on improving transfusion decisions at the bedside led to the concept of “optimal blood use”. The practice of transfusion medicine now emphasises the judicious use of transfusion, only when clinically indicated, also reflecting the fact that blood is a limited resource coming from voluntary non-remunerated blood donors. The concept that “our own blood is still the best thing to have in our veins” (Frenzel, T.; Van Aken, H.; Westphal, M. Our own blood is still the best thing to have in our veins. Current Opinion in Anaesthesiology 2008, 21, 657–663. doi: 10.1097/ ACO.0b013e3283103e84) has given rise to various surgical “blood conservation” techniques. Underlying these efforts is the broader concept of “patient blood management” (PBM). This is a patient-centred approach that addresses iron deficiency, anaemia, coagulopathy and blood loss, in both surgical and nonsurgical patients, as risk factors for adverse medical outcomes. Under PBM, anaemia and iron deficiency are recognised as serious global health issues in their own right, affecting billions of people worldwide, yet globally, there is still a gap in awareness and implementation of PBM as an overall framework to address the risks of iron deficiency, anaemia, blood loss, and coagulopathy. For this reason, the World Health Organization (WHO) recently issued a policy brief highlighting the urgent need to implement the PBM worldwide. The implementation is also supported by the desire to increase patient safety in the transfusion setting.

This Special Issue seeks to collect contributions in the form of original research, reviews, communication, comments, and evidence-based opinions on the urgent need and opportunity to implement programs for PBM adoption across worldwide and will therefore accept contributions relating to—but not limited to—clinical, transfusional, organisational, and legal aspects of the application of PBM strategies in any medical speciality.

Dr. Daniele Rodriguez
Dr. Matteo Bolcato
Dr. Vincenzo De Angelis
Dr. Vanessa Agostini
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

 

Keywords

  • patient blood management
  • transfusion
  • iron
  • folate
  • vitamin B12
  • erythropoietin
  • coagulation
  • fibrinogen
  • POC-coagulation monitoring
  • cell salvage
  • anaemia tolerance
  • transfusion trigger
  • bloodless
  • patient safety

Published Papers (2 papers)

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Research

11 pages, 235 KiB  
Article
Real-World Data Analysis of Patients Affected by Immune-Mediated Thrombotic Thrombocytopenic Purpura in Italy
by Emanuele Angelucci, Andrea Artoni, Luana Fianchi, Melania Dovizio, Biagio Iacolare, Stefania Saragoni and Luca Degli Esposti
J. Clin. Med. 2024, 13(5), 1342; https://doi.org/10.3390/jcm13051342 - 27 Feb 2024
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Abstract
Background: The therapeutic management of immune-mediated thrombotic thrombocytopenic purpura (iTTP) has recently benefited from the introduction of caplacizumab, an agent directed at the inhibition of platelet aggregation. This real-world analysis investigated the epidemiology and the demographic and clinical characteristics of iTTP patients in [...] Read more.
Background: The therapeutic management of immune-mediated thrombotic thrombocytopenic purpura (iTTP) has recently benefited from the introduction of caplacizumab, an agent directed at the inhibition of platelet aggregation. This real-world analysis investigated the epidemiology and the demographic and clinical characteristics of iTTP patients in Italy before and after caplacizumab introduction in 2020. Methods: Hospitalized adults with iTTP were included using the administrative databases of healthcare entities covering 17 million residents. Epidemiological estimates of iTTP considered the 3-year period before and after caplacizumab introduction. After stratification by treatment with or without caplacizumab, iTTP patients were characterized for their baseline features. Results: The annual incidence before and after 2020 was estimated in the range of 4.3–5.8 cases/million and 3.6–4.6 cases/million, respectively. From 2018 to 2022, 393 patients with iTTP were included, and 42 of them were treated with caplacizumab. Caplacizumab-treated patients showed better clinical outcomes, with tendentially shorter hospital stays and lower mortality rates (no treated patients died at either 1 month or 3 months after caplacizumab treatment initiation, compared to 10.5% and 11.1% mortality rates at 1 and 3 months, respectively, of the untreated ones). Conclusions: These findings may suggest that caplacizumab advent provided clinical and survival benefits for patients with iTTP. Full article
(This article belongs to the Special Issue Patient Blood Management: Advances and Perspectives)
17 pages, 1256 KiB  
Article
Massive Transfusion Increases Serum Magnesium Concentration
by Justyna Malinowska, Milena Małecka-Giełdowska, Katarzyna Pietrucha, Gabriela Górska, Dagmara Kogut and Olga Ciepiela
J. Clin. Med. 2023, 12(15), 5157; https://doi.org/10.3390/jcm12155157 - 7 Aug 2023
Cited by 2 | Viewed by 1484
Abstract
(1) Background: The massive transfusion of packed red blood cells (RBCs) is a lifesaving procedure, but it is associated with complications, e.g., dysmagnesemia. Since magnesium is an intracellular ion, the transfused RBCs can significantly influence the magnesium concentration in the recipient’s blood. (2) [...] Read more.
(1) Background: The massive transfusion of packed red blood cells (RBCs) is a lifesaving procedure, but it is associated with complications, e.g., dysmagnesemia. Since magnesium is an intracellular ion, the transfused RBCs can significantly influence the magnesium concentration in the recipient’s blood. (2) Methods: A retrospective study was performed among 49 patients hospitalized in the Central Clinical Hospital of the Medical University of Warsaw who received a massive blood transfusion (≥4 units/h). Data on laboratory results and patient history were collected from the hospital database. The intracellular RBCs magnesium concentration was measured in 231 samples using the colorimetric method. (3) Results: There were statistically significant changes in the mean serum magnesium concentration preoperatively and 24 h postoperatively (0.87 ± 0.13 vs. 1.03 ± 0.14, p < 0.00001) and 48 h postoperatively (0.87 ± 0.13 vs. 1.06 ± 0.15, p < 0.00001). Patients who died had significantly higher serum magnesium concentrations (p < 0.05). The median intracellular magnesium concentration in RBCs was 0.91 (0.55–1.8) mmol/L, which is below the reference values of 1.65–2.65 mmol/L. (4) Conclusions: Transfused RBCs significantly increased the serum magnesium concentration 24 h and 48 h postoperatively. It could be a result of mild hemolysis, as the median intracellular magnesium concentration in RBCs was below the reference values. Full article
(This article belongs to the Special Issue Patient Blood Management: Advances and Perspectives)
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