Концепция «Менеджмент крови пациенток» в практике акушера-гинеколога: на что обратить внимание?

Abstract

Aim. To present literature and own data on the implementation of the concept of patient blood management (PBM) in obstetrics and gynecology. Key points. PBM involves “the timely, interdisciplinary application of evidence-based, multimodal medical and surgical concepts aimed at screening, diagnosing and appropriately treating anemia, minimizing surgical, procedural, iatrogenic blood loss, and managing coagulopathy bleeding to improve health outcomes through patient-centered care”. As part of the PBM, it is important for the obstetrician-gynecologist to first screen for iron deficiency (ID) and identify iron deficiency anemia (IDA), prescribe treatment with modern iron preparations. A new generation of ferrous iron preparation with prolonged release is proposed, which minimizes the side effects of therapy. The second aspect is to screen and treat identified coagulation disorders using treatment algorithms based on thromboelastometry data, the third is in the postpartum/postoperative period, screen for and treat iron deficiency and anemia, control coagulation, monitor blood loss and rational use of allogeneic blood components. The results of the introduction of PBM into clinical practice of the National Medical Research Center for Obsterics, Gynecology and Perinatology named after Academician V.I. Kulakov, which allows for timely diagnosis of ID and IDA at the “Anemia-STOP!” Center, rational transfusion of allogeneic blood components, which contributed to a reduction in the volume of procured and transfused donor blood components. Conclusion. The implementation of the PBM concept helps to improve the effectiveness and safety of treatment, while promoting the best use of economic resources. Keywords: patient blood management, obstetrics, gynecology, iron deficiency anemia, new generation ferrous sulfate, coagulation control, efficiency, safety.