Tratamento de anemia perioperatória sem transfusão de sangue alogênico: proposta de abordagem multiprofissional para uso de medicamentos em apoio à gestão do sangue do paciente

• Autor(a) principal: Souza, Patrícia Carla Estevam Leal
• Data de Publicação: 2022
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UFS
• Texto Completo: http://ri.ufs.br/jspui/handle/riufs/16849
• topic: Enfermagem; Anemia; Tratamento farmacológico; Sangue – Transfusão; Blood - Transfusion; Nursing; Anemia; Pharmacological treatment; CIENCIAS DA SAUDE

Introduction: Blood is a therapeutic resource widely used by medicine in order to allow cellular oxygenation in cases of blood loss. However, allogeneic blood is a scarce resource, with short to long-term post-transfusion risks, expensive, and may not be available to meet a medical request due to its lack or because it is not a treatment option for the patient. Since 1999, WHO has encouraged the use of other therapeutic options for blood and guides the implementation of Patient Blood Management, in English, known as Patient Blood Management (PBM). Management is based on 3 pillars: increasing the production of the patient's red blood cells, preventing or reducing blood loss, and supporting the patient's anemia tolerance. Multiprofessional action in blood management is essential and it is necessary that each professional knows about their possibilities of action. Objectives: To develop a proposal for a multiprofessional approach for the use of drugs as treatment of perioperative anemia without allogeneic blood transfusion for doctors, nurses and pharmacists at the HU/UFS. Methodology: First, an integrative literature review was performed to identify the drugs, clinical manifestations of patients treated with drugs and patient care using the descriptors: anemia, bloodless medical and surgical procedures, operative blood salvage and blood substitutes. The databases used were PUBMED, LILACS, CINAHL, Wed of Science and SCOPUS. Then, the data on the drugs in the selected articles were compared with national and international protocols was carried out. Points of consideration for clinical reasoning in the treatment of patients without the use of allogeneic blood, the list of identified drugs, the clinical manifestations resulting from the treatment, the care offered were transferred from the integrative review to the proposal of a multiprofessional approach. Results: Of the seventy drugs identified, 18% are erythropoiesis-stimulating agents, 36% are hemostatic agents, and 9% are drugs that improve oxygen delivery and consumption. Of the medicines standardized in the HU-UFS are 65.7% of the medicines identified. Of the 48 clinical manifestations identified, 42% indicated patient recovery or stability, 58% indicated patient instability. The studies brought eight care with patients who are already known by medicine, pharmacy and nursing; this amount was increased by 31 care with the classification system of nursing interventions. Conclusion: The use of drugs as a therapeutic option to allogeneic blood for the treatment of perioperative anemia is possible to be implemented in the HU-UFS because it has most of the identified ones. The involvement of a multiprofessional team enhances success in the implementation of patient blood management.