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Critical Care Society of Southern Africa adult patient blood management guidelines: 2019 Round-table meeting, CCSSA Congress, Durban, 2018
Abstract
The CCSSA PBM Guidelines have been developed to improve patient blood management in critically ill patients in southern Africa. These
consensus recommendations are based on a rigorous process by experts in the field of critical care who are also practicing in South Africa (SA). The
process comprised a Delphi process, a round-table meeting (at the CCSSA National Congress, Durban, 2018), and a review of the best available
evidence and international guidelines. The guidelines focus on the broader principles of patient blood management and incorporate transfusion
medicine (transfusion guidelines), management of anaemia, optimisation of coagulopathy, and administrative and ethical considerations. There
are a mix of low-middle and high-income healthcare structures within southern Africa. Blood products are, however, provided by the same notfor-
profit non-governmental organisations to both private and public sectors. There are several challenges related to patient blood management
in SA due most notably to a high incidence of anaemia, a frequent shortage of blood products, a small donor population, and a healthcare system
under financial strain. The rational and equitable use of blood products is important to ensure best care for as many critically ill patients as
possible. The summary of the recommendations provides key practice points for the day-to-day management of critically ill patients. A more
detailed description of the evidence used to make these recommendations follows in the full clinical guidelines section.
Authors' affiliations
R D Wise, Discipline of Anaesthesiology and Critical Care, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
K de Vasconcellos, Department of Critical Care, King Edward VIII Hospital, Durban; Discipline of Anaesthesiology and Critical Care, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
D Gopalan, Discipline of Anaesthesiology and Critical Care, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
N Ahmed, Surgical ICU, Tygerberg Academic Hospital; Department of Surgical Sciences and Department of Anaesthesiology and Critical Care, Stellenbosch University, Cape Town, South Africa
A Alli, Department of Anaesthesia, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
I Joubert, Division of Critical Care, Department of Anaesthesia and Perioperative Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
K F Kabambi, Department of Anaesthesia and Critical Care, Nelson Mandela Academic Hospital, Mthatha; Department of Surgery, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa
L R Mathiva, Intensive Care Unit, Chris Hani Baragwanath Academic Hospital and University of the Witwatersrand, Johannesburg, South Africa
N Mdladla, Dr George Mukhari Academic Hospital; Sefako Makgatho Health Sciences University, Pretoria, South Africa
M Mer, Department of Medicine, Divisions of Critical Care and Pulmonology, Charlotte Maxeke Johannesburg Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
M Miller, Department of Anaesthesia and Peri-operative Medicine, Division of Critical Care, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
B Mrara, Anaesthesia Department, Walter Sisulu University, Mthatha, South Africa
S Omar, Department of Critical Care, Chris Hani Baragwanath Academic Hospital and School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
F Paruk, Department of Critical Care, Steve Biko Academic Hospital and Critical Care, School of Medicine, University of Pretoria, South Africa
D Skinner, Department of Critical Care, King Edward VIII Hospital, Durban; Discipline of Anaesthesiology and Critical Care, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
R von Rahden, Private practice (Critical Care), Rodseth and Partners, Pietermaritzburg, South Africa
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Date published: 2020-08-04
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