I found out that a german company is already offering a system for automatic bleeding control in ICU for hospitals. The company promotes its product with the standard benefits mentioned for a PBM. The company even cited Prof. Hofmann in a press release.
ROTEM is a german company that offers
i.a. a ROTEM sigma - a system for automatic bleeding control that enables an
improved patient blood managment. The product and methodology is
explained on the company's page. https://www.rotem.de/en/products/rotem-sigma/
The benefits according to product folders:
- reduction of infection
rate,
- reduction of hospital costs as well as
- mortality
Ensuring both, the quality
and the supply of blood products is becoming increasingly difficult.
This is leading to a more rational use of the limited resource
“blood“ and to a critical view on the need of blood transfusions.
Blood loss, anaemia and blood transfusions are independent predictors
for worse outcomes and patients´ quality of life. This includes an
increase in morbidity and mortality, as well as a prolongation of the
average length of hospital stay. In short, transfusions typically
lead to avoidable complications and costs. In this context, the
targeted ROTEM®-based bleeding management is an integral part of
Patient Blood Management that is predicated on both preemptive and
reactive blood-saving measures. In fact, the WHO has encouraged all
their 193 member states with the WHA 63.12 to implement the PBM
concept in a timely mann
Under the BENEFITS of a Patient blood management you find:
https://www.youtube.com/watch?v=I0Ulmt0dcSQ
Blood is the most valuable liquid in
the world
It transports oxygen, nutritional
substances and connects our organs, playing a vital role in keeping
us alive.
Blood donators give their blood to
others and make it possible to save severely injured people and carry
out large operations.
Meanwhile numerous multi-centric
studies have shown that an unnecessary transfusion of allogenic blood
products is associated with increased mortality, an increased
complication rate (e.g. lung injury and kidney failure) and infection
risk (e.g. nosocomial infection and sepsis).
Therefore blood should be seen as a
drug with a clear indication and a significant range of adverse
effects.
Due to the current demographic
changes it becomes apparent that there is already a substantial
shortage of blood products, which is based on a continuous and future
decrease in suitable blood donors – while there is a growing need
and steadily growing numer of surgical procedures.
Further I found an interesting press release of the SIGMA company from 2015 which is citing Prof. Dr. Axel Hofmann about the advantages of PBM:
According
to Dr. Axel Hofmann, visiting professor at the Department of
Anesthesiology, University Hospital Zurich, improved disease course
may be determined by the reduction or complete avoidance of the use
of allogenic blood:
"The
preservation of the patient's own blood during a surgical procedure
often results in a lesser period of IICU stay and in the hospital.
Moreover, the mortality and the risk of infection after surgery can
be massively reduced. Consequently, also costs for the health system
associated with a transfusion, for example, for the blood bank,
laboratory operations, hospitalization or follow-up treatment can be
avoided to a large extent through the use of effective bleeding
management".
___
Then I found on Qoutube a video in which Prof. Axel Hofmann is lecturing about the economic reasons that convinced the Western Australian Government to shift the paradigm and implement a PBM.
(Start at 11:20 to to hear about the cost factor)
https://www.youtube.com/watch?v=hJMaLcAWGNM
Further a published article about the economic considerations
(Hofmann, Ozawa, Farrugia, Farmer,
Shander)
https://www.ncbi.nlm.nih.gov/pubmed/23590916
