Elektronisk udgave - Sundhedsstyrelsen

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❖ The use of blood-saving technologies which have proved to be
clinically effective and cost-effective, according to carefully determined
indications and clinical practice guidelines.
As to most of the technologies, the number of studies suitable to be
included in ISPOT-analyses was small, and the available studies
were often inconclusive as regards cost-effectiveness. To this must
be added that the side effects and the costs relating to such side effects
have only been described in very few studies.
Against this background it is not possible to reach any final conclusions
with regard to the applicability and utility of the technologies.
As mentioned autotranfusion/CS is of interest from a clinical
point of view. It appears that the use of some technologies (TXA,
aprotinin and possibly ANH, too, if low hemoglobin values are
accepted in connection with surgery) would be acceptable from a
point of view primarily based on cost-effectiveness.
However, this should be related to the effect of an optimisation of
surgical and anesthesiological techniques and the development of
and adherence to appropriate and suitable transfusion protocols.
Measures of this nature might prove to be more cost-effective than
the use of the technologies, and they will be desirable long-term objectives
to work towards in any case.
As far as the technologies are concerned, further substantiation of
their effectiveness will be required. A further up-date of the ISPOTmeta-analyses
is to be done within the auspices of the Cochrane
Collaboration.
Contrary to systematic reviews regarding clinical effects, economic
analyses are generally not easy to apply to other countries. Consequently,
relevant Danish economic analyses must be conducted in
connection with the use of each individual technology in Denmark.