Calculadora – Calculadora MCP

Descrição hipotética para fins de cálculo

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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.

Tratamento com a utilização de sangue:

Concentrado de Hemácias – 6 bolsas
Valor unitário: R$ 1.948,94

Tratamento sem a utilização de sangue:

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$ 14,10

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$ 46,50

Máquina Recuperadora de Células Intra-Operatória – 1 Kit durante a cirurgia
Valor unitário: R$ 1.500,00

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$ 11,50

Referências científicas:

Links Úteis:
PBM – Normas em Português
https://sabm.org/
https://nataonline.com/
https://www.ifpbm.org/
https://www.blood.gov.au/pbm-guidelines

Referencias Científicas:

Althoff FC et al. Multimodal patient blood management program based on a three-pillar strategy: a systematic review and meta-analysis. Ann Surg. 2019;269(5):794-804.
https://pubmed.ncbi.nlm.nih.gov/30418206/

Simon F, Joshua G, Husein M, Kednapa T, Daniel I. Hospital cost associated with anemia in elective colorectal surgery: a historical cohort study. Canadian Journal of Anesthesia. 2019;66:877–885.
https://link.springer.com/article/10.1007/s12630-019-01379-8

Meybohm P, Straub N, Füllenbach C, Adina L J, Isabel K T, Zacharowski K, Choorapoikayil S. Health economics of Patient Blood Management: a cost-benefit analysis based on a meta-analysis. The International Journal of Transfuse Medicine. 2020;115(2):182-188.
https://onlinelibrary.wiley.com/doi/epdf/10.1111/vox.12873

Gombotz H, Hofmann A, Nørgaard A, Kastner P. European Comission (Directorate-General for Health and Food Safety) Supporting Patient Blood Management (PBM) in the EU – A practical implementation guide for hospitals: Technical Report. Luxembourg: Publications Office of the European Union. 2017.
https://ec.europa.eu/health/sites/default/files/blood_tissues_organs/docs/2017_eupbm_hospitals_en.pdf

World Health Organization. WHA63.12 Availability, safety and quality of blood products. Geneva: World Health Organization. 2010.
https://www.who.int/publications/i/item/availability-safety-and-quality-of-blood-products-(wha63.12)

Meybohm P et al. Patient blood management bundles to facilitate implementation. Transfus Med Rev. 2017;31(1):62-71.
https://pubmed.ncbi.nlm.nih.gov/27317382/

Leahy MF et al. 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. 2017;57(6):1347-58.
https://pubmed.ncbi.nlm.nih.gov/28150313/

Meybohm P et al., Patient Blood Management is Associated with a Substantial Reduction of Red Blood Cell Utilization and safe for Patient’s Outcome. Ann Surg. 2016;264(2):203-11.
https://pubmed.ncbi.nlm.nih.gov/27163948/

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/

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

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/

Carson JL, Reynolds RC, Klein HG. Bad bad blood? Crit Care Med. 2008;36(9):2707-8.
https://jhu.pure.elsevier.com/en/publications/bad-bad-blood-4

Australian Government Health. National Blood Authority. Australia: abril/2021;
https://www.blood.gov.au/patient-blood-management-pbm.

Referências científicas:

X

Links Úteis:
PBM – Normas em Português
https://sabm.org/
https://nataonline.com/
https://www.ifpbm.org/
https://www.blood.gov.au/pbm-guidelines

Referencias Científicas:

Althoff FC et al. Multimodal patient blood management program based on a three-pillar strategy: a systematic review and meta-analysis. Ann Surg. 2019;269(5):794-804.
https://pubmed.ncbi.nlm.nih.gov/30418206/

Simon F, Joshua G, Husein M, Kednapa T, Daniel I. Hospital cost associated with anemia in elective colorectal surgery: a historical cohort study. Canadian Journal of Anesthesia. 2019;66:877–885.
https://link.springer.com/article/10.1007/s12630-019-01379-8

Meybohm P, Straub N, Füllenbach C, Adina L J, Isabel K T, Zacharowski K, Choorapoikayil S. Health economics of Patient Blood Management: a cost-benefit analysis based on a meta-analysis. The International Journal of Transfuse Medicine. 2020;115(2):182-188.
https://onlinelibrary.wiley.com/doi/epdf/10.1111/vox.12873

Gombotz H, Hofmann A, Nørgaard A, Kastner P. European Comission (Directorate-General for Health and Food Safety) Supporting Patient Blood Management (PBM) in the EU – A practical implementation guide for hospitals: Technical Report. Luxembourg: Publications Office of the European Union. 2017.
https://ec.europa.eu/health/sites/default/files/blood_tissues_organs/docs/2017_eupbm_hospitals_en.pdf

World Health Organization. WHA63.12 Availability, safety and quality of blood products. Geneva: World Health Organization. 2010.
https://www.who.int/publications/i/item/availability-safety-and-quality-of-blood-products-(wha63.12)

Meybohm P et al. Patient blood management bundles to facilitate implementation. Transfus Med Rev. 2017;31(1):62-71.
https://pubmed.ncbi.nlm.nih.gov/27317382/

Leahy MF et al. 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. 2017;57(6):1347-58.
https://pubmed.ncbi.nlm.nih.gov/28150313/

Meybohm P et al., Patient Blood Management is Associated with a Substantial Reduction of Red Blood Cell Utilization and safe for Patient’s Outcome. Ann Surg. 2016;264(2):203-11.
https://pubmed.ncbi.nlm.nih.gov/27163948/

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/

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

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/

Carson JL, Reynolds RC, Klein HG. Bad bad blood? Crit Care Med. 2008;36(9):2707-8.
https://jhu.pure.elsevier.com/en/publications/bad-bad-blood-4

Australian Government Health. National Blood Authority. Australia: abril/2021;
https://www.blood.gov.au/patient-blood-management-pbm.

Saiba mais:

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Custos unitários do hospital

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Concentrado de Hemácias
Diária de Leito Enfermaria
Terapia com Ferro
(Noripurum® 100mg)
Eritropoetina
(Hemax® 4.000 UI)
Ácido Tranexâmico (Transamin® 50 mg/ml)
Máquina Recuperadora
de Células Intra-Operatória

Calculadora MCP

Calculadora de Manejo Cirúrgico Perioperatório

Paciente cirúrgico (sem preparo)

Paciente cirúrgico (com preparo)

Estimativa de resultados