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Órgano oficial de difusión de la Federación Mexicana de Patología Clínica, AC y de la Asociación Latinoamericana de Patología Clínica/Medicina de Laboratorio

2006, Number 4

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Rev Mex Patol Clin Med Lab 2006; 53 (4)

The practice of transfusional medicine based upon evidences

Rodríguez MH

Language: Spanish
References: 42
Page: 197-208
PDF size: 130.81 Kb.


ABSTRACT

A certain number of evidence based medicine (EBM) works has been published recently. EBM is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. Evidences are obtained from clinical investigation, by research on the basic sciences of medicine such as biochemistry and genetics and evaluation on accuracy and precision of diagnostic tests and other biomedical parameters. Even as EBM is a promoted new discipline, Paracelsus in XVIth Century condemned all medical teaching not based on experience, and the English James Blundell in XIXth Century transfused successfully several post-partum bleeding women. It is mandatory to use Evidence Based Transfusion Medicine (EBTM) in order to avoid unjustified transfusions, its risk, and to impel clinical and biochemical research on risks and benefits of blood transfusion. Blood transfusion is justified in two circumstances: anemia and bleeding. These have great clinical importance in acute bleeding surgical or traumatic anemia. The unsolved risk in blood transfusion is astonishingly the incorrect blood component transfusion; as it is more frequent in clinical wards, it is imperative to maintain yearly actualization for the medical and nurse staff. Five levels on scientific evidence have been distinguished in EBM and EBTM articles according with its scientific evidence level; randomized comparative clinical trials (double blind controlled trials) are the higher level; those of expert opinion observational studies are the lower. In conclusion EBTM is an alive discipline engaged with best evidences clinical applications on the judicious transfusion of blood components and with the research for resolution of still badly unknown patients risks and benefits.


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