Basics of Blood Management (2007)

System. 1. History and Organization of Blood Management * Blood management as a program * The administrative part * The physician's part. 2. Physiology of Anemia and Oxygen Transport * Regular physiology * Physiology of anemia * Relationship between oxygen delivery and oxygen consumption * Practical implications. 3. Anemia Therapy, Part 1 (EPO, NESP and Anabolics) * Erythropoietin in normal erythropoiesis * Erythropoietin as a drug * Novel erythropoiesis stimulating protein (NESP, Darbepoetin) * Anabolic steroids. 4. Fluids * Need for fluid therapy * Basics of volume household and iv fluids * Crystalloid solutions * Colloid solutions * Side effects * Fluids at work * Influence of fluid therapy on blood management. 5. Use of Autologous Blood * Preoperative autologous donation * Hemodilution * Comparison of PAD and ANH * Platelet and Plasmapheresis. 6. Preparation of the Patient for Surgery * History and physical examination * Laboratory and other tests * Plan of care * Preparation. 7. Law, Ethics, Religion and Blood Management * Principles as basis for decision-making in blood management * Principles of bioethics * Human rights and patient's rights * Excursus * Jehovah's Witnesses * Compassionate use. 8. Recombinant Blood Products * Basics of recombinant drugs * Use of recombinant blood proteins in blood management * Comparison of recombinant and plasma-derived blood proteins. 9. Anemia Therapy, Part 2 (Hematinics * Physiology of erythropoiesis and hemoglobin synthesis * Iron therapy in blood management * Copper * Vitamin therapy in blood management * Interactions of hematinics * Implications for blood management. 10. Iatrogenic Blood Loss * Causes of iatrogenic blood loss * The role of iatrogenic blood loss in blood management * Avoidance of iatrogenic blood loss. 11. Antifibrinolytics, Vitamin K and Estrogens * Antifibrinolytics * Desmopressin * Vitamins of the K-Group * Conjugated estrogens and other hormones * Other hemostatic drugs. 12. Surgery: They Physics of Hemostasis * Basics of surgical techniques * Surgical tools * Methods to achieve hemostasis and to avoid undue blood loss * Positioning * Methods for surgical cutting . 13. Cell Salvage * Cell savers * Advantages of cell salvage * Practical considerations for cell salvage * Risks and side effects of cell salvage * Concerns: how to overcome contraindications * Indications for cell salvage * Cell salvage and concomitant diseases. 14. Tranfusions, Part A (Cellular Components, Plasma) * Why do physicians transfuse? * Ordering blood products * Risks and side effects of transfusions * Outcome measures * Guidelines * Leukoreduction * Massive transfusion * Practical management of transfusion * Levels of evidence/grades of recommendations. 15. Oxygen Therapy * Physics and physiology of oxygen * Oxygen, friend and enemy * Efects of pressurized oxygen on the human body * Normobaric inhalational oxygen therapy * Hyperbaric oxygen * Oxygen in blood management. 16. Artificial Blood Components * Artificial oxygen carriers * Hemoglobin-based oxygen carriers (HBOC) * Perfluorocarbons (PFC) * Artificial oxygen carriers in blood mangement * Other attempts to make artificial blood components. 17. Transfusions, Part B (Plasma Fractions) * The anatomy of plasma * Plasma fractions * Plasma fractions in blood management * Approaches to reduce the use of plasmatic fractions. 18. Blood Banking * Blood safety * What is test for in blood products and how * Storage and delivery * Whole blood to cellular components * Leukocyte depletion * Bacterial contamination * Plasma fractionation * Pathogen reduction * The interaction of blood banks and clinicians. 19. Cost Considerations * Basics of medical economy * Methods to calculate costs of a medical product or service * Costs of transfusion * Costs of methods to reduce transfusion requirements * Costs of a blood management program. 20. Step by Step to an Organized Blood Management System. 21. Law, ethics, religion, and blood management. 22.Step by step to an organized blood management program. Appendix A: Detailed information. Appendix B: Sources of information for blood management. Appendix C: Program tools and forms. Appendix D: Teaching aids: research and projects. Appendix E: Address book. Index