Paciente cirúrgico (sem preparo)
Paciente cirúrgico (com preparo)
(Noripurum® 100mg) R$ 0,00
(Hemax® 4.000 UI) R$ 0,00
Estimativa de resultados

O cálculo a seguir é baseado em um paciente hipotético conforme descrito abaixo. Sabemos que há muitos ítens e aspectos envolvidos, porém, o objetivo é ajudar a ver a diferença econômica e o custo x benefício de uma abordagem de gerenciamento de sangue.
Paciente adulto 70kg, candidato a cirurgia cardíaca eletiva com Hb 7,0 g/dl. Proposta de tratamento da anemia em 4 semanas pré-cirurgia para aumento de Hb para 13,0 g/dl.
Concentrado de Hemácias – 6 bolsas
Valor unitário: R$ 1.948,94
Correção do Ferro: Noripurum® 100mg – 15 ampolas
Pela fórmula de Ganzoni, déficit de ferro é de 1500 mg.
Cada ampola de Noripurum® tem 100 mg de ferro, portanto, 15 ampolas de Noripurum®.
Valor unitário: R$ 17,00
Eritropoetina – 4.000 UI – 55 ampolas
Dose 600 UI/kg/semana = 42.000 UI.
Hemax® 4.000 UI: 11 frascos (44.000 UI) 1x/semana por 4 semanas e no dia da cirurgia.
Total: 11 ampolas x 5 = 55 ampolas de Hemax® 4.000 UI
Valor unitário: R$ 55,00
Máquina de Recuperação Intraoperatória de Sangue + 1 Kit durante a cirurgia
Valor unitário: R$ 5.000,00
Ácido Tranexâmico – 10 ampolas de 250 mg
Dose: 35 mg/kg: 35 x 70 = 2450 mg
Cada ampola de Transamin® tem 5 ml, na dose de 50 mg/ml, portanto cada ampola tem 250 mg.
Logo, 10 ampolas de Transamin® darão os 2450 mg que o paciente precisa.
Valor unitário: R$ 13,00
https://www.gov.br/saude/pt-br/assuntos/saude-de-a-a-z/g/gerenciamento-de-sangue-do-paciente
Referencias Científicas:
Althoff, F. C., Neb, H., Herrmann, E., Trentino, K. M., Vernich, L., Füllenbach, C., Freedman, J., Waters, J. H., Farmer, S., Leahy, M. F., Zacharowski, K., Meybohm, P., & Choorapoikayil, S. (2019). Multimodal Patient Blood Management Program Based on a Three-pillar Strategy: A Systematic Review and Meta-analysis. Annals of Surgery, 269(5), 794–804. https://doi.org/10.1097/SLA.0000000000003095
Australian Government Health. National Blood Authority. Australia: abril/2021.
https://www.blood.gov.au/clinical-guidance/patient-blood-management/patient-blood-management-pbm-resources
Céspedes, I. C.; Figueiredo, M. S.; Hossne, N. A. Júnior; et al. Patient Blood Management Program Implementation: Comprehensive Recommendations and Practical Strategies. Brazilian Journal of Cardiovascular Surgery, 2024 Aug 2;39(5).
https://pressreleases.scielo.org/blog/2024/12/04/recomendacoes-abrangentes-e-estrategias-praticas-na-implementacao-do-pbm/
Delaforce, A., Duff, J., Munday, J., & Hardy, J. (2020). Overcoming barriers to evidence-based patient blood management: A restricted review. Implementation Science, 15(1), 1–13. https://doi.org/10.1186/s13012-020-0965-4
European Commission. (2017). Commission publishes guides on patient blood management.
https://ec.europa.eu/newsroom/sante/newsletter-specific-archive-issue.cfm?newsletter_service_id=327&newsletter_issue_id=3143
Freedman, J. (2016). Transfusion Medicine: Time for a Change: Patient Blood Management and the Ontario ONTraC Program. Journal of Perioperative & Critical Intensive Care Nursing, 2(2). https://doi.org/10.4172/2471-9870.1000123
Hofmann A, Ozawa S, Farrugia A, Farmer S L, Shander A. Economic considerations on transfusion medicine and patient blood management. Best Pract Res Clin Anaesthesiol. 2013;27(1):59-68. https://www.sciencedirect.com/science/article/abs/pii/S1521689613000177
Hofmann A, Shander A, Blumberg N, Hamdorf M J, Isbister P J, Gross I. Patient Blood Management: Improving Outcomes for Millions While Saving Billions. What Is Holding It Up? https://pubmed.ncbi.nlm.nih.gov/35977361/
Isbister, J. P., Shander, A., Spahn, D. R., Erhard, J., Farmer, S. L., & Hofmann, A. (2011). Adverse Blood Transfusion Outcomes: Establishing Causation. Transfusion Medicine Reviews, 25(2), 89–101. https://doi.org/10.1016/j.tmrv.2010.11.001
Kaserer, A., Rössler, J., Braun, J., Farokhzad, F., Pape, H. C., Dutkowski, P., Plass, A., Horisberger, T., Volbracht, J., Manz, M. G., & Spahn, D. R. (2019). Impact of a Patient Blood Management monitoring and feedback programme on allogeneic blood transfusions and related costs. Anaesthesia, 74(12), 1534–1541. https://doi.org/10.1111/anae.14816
Leahy, M. F., Hofmann, A., Towler, S., Trentino, K. M., Burrows, S. A., Swain, S. G., Hamdorf, J., Gallagher, T., Koay, A., Geelhoed, G. C., & Farmer, S. L. (2017). Improved outcomes and reduced costs associated with a health-system-wide patient blood management program: a retrospective observational study in four major adult tertiary-care hospitals. Transfusion, 57(6), 1347–1358. https://doi.org/10.1111/trf.14006
Lenzer, J., Hoffman A., J. R., Furberg, C. D., & Ioannidis, J. P. A. (2013). Ensuring the integrity of clinical practice guidelines: a tool for protecting patients. BMJ, 347. https://doi.org/10.1136/bmj.f5535
Mehra T, Seifert B, Bravo-Reiter S, Wanner G, Dutkowski P, Holubec T, Moos M R, Volbracht J, Manz G M, Spahn R D. Implementation of a patient blood management monitoring and feedback program significantly reduces transfusions and costs. Transfusion. 2015;55(12):2807-15. https://pubmed.ncbi.nlm.nih.gov/26264557/
Meybohm, P., Straub, N., Füllenbach, C., Judd, L., Kleinerüschkamp, A., Taeuber, I., Zacharowski, K., & Choorapoikayil, S. (2020). Health economics of Patient Blood Management: a cost-benefit analysis based on a meta-analysis. Vox Sanguinis, 115(2), 182–188. https://doi.org/10.1111/vox.12873
Pfuntner, A., Wier, L. M., & Stocks, C. (2013). Most Frequent Procedures Performed in U.S. Hospitals, 2011: Statistical Brief #165. Healthcare Cost and Utilization Project (HCUP) Statistical Briefs [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US). http://www.ncbi.nlm.nih.gov/pubmed/24354027
Shander, A., Goobie, S. M., Warner, M. A., Aapro, M., Bisbe, E., Perez-Calatayud, A. A., Callum, J., Cushing, M. M., Dyer, W. B., Erhard, J., Faraoni, D., Farmer, S., Fedorova, T., Frank, S. M., Froessler, B., Gombotz, H., Gross, I., Guinn, N. R., Haas, T., … Group., on behalf of the I. F. of P. B. M. (IFPBM) and S. for the A. of B. M. (SABM) W. (2020). The Essential Role of Patient Blood Management in a Pandemic: A Call for Action. Anesthesia & Analgesia, Publish Ah. https://doi.org/10.1213/ane.0000000000004844
Stokes E M, Ye X, Shah M, Mercaldi K, Reynolds W M, Rupnow F T M, Hammond J. Impact of bleeding-related complications and/or blood product transfusions on hospital costs in inpatient surgical patients. BMC Health Serv Res. 2011;(31)11:135. https://pubmed.ncbi.nlm.nih.gov/21627788/
Trentino, K., Farmer, S., Gross, I., Shander, A., & Isbister, J. (2016). Observational studies – should we simply ignore them in assessing transfusion outcomes? BMC Anesthesiology, 16(1), 96. https://doi.org/10.1186/s12871-016-0264-4
World Health Organization. (2011). Global Forum for Blood Safety: Patient Blood Management (PBM) Structured observations. March, 14–15.
https://www.who.int/news-room/events/detail/2011/03/14/default-calendar/who-global-forum-for-blood-safety-patient-blood-management
World Health Organization. (2021). The urgent need to implemente Patient Blood Management: Policy Brief.
https://apps.who.int/iris/bitstream/handle/10665/346655/9789240035744-eng.pdf
World Health Organization (2025). Guidance on implementing patient blood management to improve global blood health status
https://www.who.int/publications/i/item/9789240104662
https://www.gov.br/saude/pt-br/assuntos/saude-de-a-a-z/g/gerenciamento-de-sangue-do-paciente
Referencias Científicas:
Althoff, F. C., Neb, H., Herrmann, E., Trentino, K. M., Vernich, L., Füllenbach, C., Freedman, J., Waters, J. H., Farmer, S., Leahy, M. F., Zacharowski, K., Meybohm, P., & Choorapoikayil, S. (2019). Multimodal Patient Blood Management Program Based on a Three-pillar Strategy: A Systematic Review and Meta-analysis. Annals of Surgery, 269(5), 794–804. https://doi.org/10.1097/SLA.0000000000003095
Australian Government Health. National Blood Authority. Australia: abril/2021.
https://www.blood.gov.au/clinical-guidance/patient-blood-management/patient-blood-management-pbm-resources
Céspedes, I. C.; Figueiredo, M. S.; Hossne, N. A. Júnior; et al. Patient Blood Management Program Implementation: Comprehensive Recommendations and Practical Strategies. Brazilian Journal of Cardiovascular Surgery, 2024 Aug 2;39(5).
https://pressreleases.scielo.org/blog/2024/12/04/recomendacoes-abrangentes-e-estrategias-praticas-na-implementacao-do-pbm/
Delaforce, A., Duff, J., Munday, J., & Hardy, J. (2020). Overcoming barriers to evidence-based patient blood management: A restricted review. Implementation Science, 15(1), 1–13. https://doi.org/10.1186/s13012-020-0965-4
European Commission. (2017). Commission publishes guides on patient blood management.
https://ec.europa.eu/newsroom/sante/newsletter-specific-archive-issue.cfm?newsletter_service_id=327&newsletter_issue_id=3143
Freedman, J. (2016). Transfusion Medicine: Time for a Change: Patient Blood Management and the Ontario ONTraC Program. Journal of Perioperative & Critical Intensive Care Nursing, 2(2). https://doi.org/10.4172/2471-9870.1000123
Hofmann A, Ozawa S, Farrugia A, Farmer S L, Shander A. Economic considerations on transfusion medicine and patient blood management. Best Pract Res Clin Anaesthesiol. 2013;27(1):59-68. https://www.sciencedirect.com/science/article/abs/pii/S1521689613000177
Hofmann A, Shander A, Blumberg N, Hamdorf M J, Isbister P J, Gross I. Patient Blood Management: Improving Outcomes for Millions While Saving Billions. What Is Holding It Up? https://pubmed.ncbi.nlm.nih.gov/35977361/
Isbister, J. P., Shander, A., Spahn, D. R., Erhard, J., Farmer, S. L., & Hofmann, A. (2011). Adverse Blood Transfusion Outcomes: Establishing Causation. Transfusion Medicine Reviews, 25(2), 89–101. https://doi.org/10.1016/j.tmrv.2010.11.001
Kaserer, A., Rössler, J., Braun, J., Farokhzad, F., Pape, H. C., Dutkowski, P., Plass, A., Horisberger, T., Volbracht, J., Manz, M. G., & Spahn, D. R. (2019). Impact of a Patient Blood Management monitoring and feedback programme on allogeneic blood transfusions and related costs. Anaesthesia, 74(12), 1534–1541. https://doi.org/10.1111/anae.14816
Leahy, M. F., Hofmann, A., Towler, S., Trentino, K. M., Burrows, S. A., Swain, S. G., Hamdorf, J., Gallagher, T., Koay, A., Geelhoed, G. C., & Farmer, S. L. (2017). Improved outcomes and reduced costs associated with a health-system-wide patient blood management program: a retrospective observational study in four major adult tertiary-care hospitals. Transfusion, 57(6), 1347–1358. https://doi.org/10.1111/trf.14006
Lenzer, J., Hoffman A., J. R., Furberg, C. D., & Ioannidis, J. P. A. (2013). Ensuring the integrity of clinical practice guidelines: a tool for protecting patients. BMJ, 347. https://doi.org/10.1136/bmj.f5535
Mehra T, Seifert B, Bravo-Reiter S, Wanner G, Dutkowski P, Holubec T, Moos M R, Volbracht J, Manz G M, Spahn R D. Implementation of a patient blood management monitoring and feedback program significantly reduces transfusions and costs. Transfusion. 2015;55(12):2807-15. https://pubmed.ncbi.nlm.nih.gov/26264557/
Meybohm, P., Straub, N., Füllenbach, C., Judd, L., Kleinerüschkamp, A., Taeuber, I., Zacharowski, K., & Choorapoikayil, S. (2020). Health economics of Patient Blood Management: a cost-benefit analysis based on a meta-analysis. Vox Sanguinis, 115(2), 182–188. https://doi.org/10.1111/vox.12873
Pfuntner, A., Wier, L. M., & Stocks, C. (2013). Most Frequent Procedures Performed in U.S. Hospitals, 2011: Statistical Brief #165. Healthcare Cost and Utilization Project (HCUP) Statistical Briefs [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US). http://www.ncbi.nlm.nih.gov/pubmed/24354027
Shander, A., Goobie, S. M., Warner, M. A., Aapro, M., Bisbe, E., Perez-Calatayud, A. A., Callum, J., Cushing, M. M., Dyer, W. B., Erhard, J., Faraoni, D., Farmer, S., Fedorova, T., Frank, S. M., Froessler, B., Gombotz, H., Gross, I., Guinn, N. R., Haas, T., … Group., on behalf of the I. F. of P. B. M. (IFPBM) and S. for the A. of B. M. (SABM) W. (2020). The Essential Role of Patient Blood Management in a Pandemic: A Call for Action. Anesthesia & Analgesia, Publish Ah. https://doi.org/10.1213/ane.0000000000004844
Stokes E M, Ye X, Shah M, Mercaldi K, Reynolds W M, Rupnow F T M, Hammond J. Impact of bleeding-related complications and/or blood product transfusions on hospital costs in inpatient surgical patients. BMC Health Serv Res. 2011;(31)11:135. https://pubmed.ncbi.nlm.nih.gov/21627788/
Trentino, K., Farmer, S., Gross, I., Shander, A., & Isbister, J. (2016). Observational studies – should we simply ignore them in assessing transfusion outcomes? BMC Anesthesiology, 16(1), 96. https://doi.org/10.1186/s12871-016-0264-4
World Health Organization. (2011). Global Forum for Blood Safety: Patient Blood Management (PBM) Structured observations. March, 14–15.
https://www.who.int/news-room/events/detail/2011/03/14/default-calendar/who-global-forum-for-blood-safety-patient-blood-management
World Health Organization. (2021). The urgent need to implemente Patient Blood Management: Policy Brief.
https://apps.who.int/iris/bitstream/handle/10665/346655/9789240035744-eng.pdf
World Health Organization (2025). Guidance on implementing patient blood management to improve global blood health status
https://www.who.int/publications/i/item/9789240104662