Patient Blood Management: A Patient-Orientated Approach to Blood Replacement with the Goal of Reducing Anemia, Blood Loss and the Need for Blood Transfusion in Elective Surgery

Abstract

Patient Blood Management (PBM) describes an evidence-based, multidisciplinary therapeutic approach. Its focus is on the treatment of the individual patient and as such comprises transfusion therapy and pharmacotherapy. Furthermore, the applicability of PBM is not limited to the perioperative setting but is applicable also to other therapeutic measures and disciplines where significant blood loss is known to occur and where transfusion of blood products is part of the established treatment. PBM is fundamentally based on 3 pillars: (1) optimization of the (preoperative) erythrocyte volume, (2) reduction of diagnostic, therapeutic, or intraoperative blood loss, and (3) increasing individual tolerance towards anemia and accurate blood transfusion triggers. PBM primarily identifies patients at risk of transfusion and provides a management plan aimed at reducing or eliminating the risk of anemia and the need for allogeneic transfusion, thus reducing the inherent risks, inventory pressures, and the escalating costs associated with transfusion.

Implementing a patient blood management programme in Brazil: challenges and implications for developing countries

“…This number differs significantly from that found in the group of patients who had normal haemoglobin levels prior to surgery: only 7% of these patients required transfusion of packed RBC intra‐ or postoperatively. These results confirmed the association between preoperative anaemia and the need for transfusion of RBC, as previously described in other studies .…”

Allogeneic blood transfusion and the prognosis of gastric cancer patients: Systematic review and meta-analysis

“…Patient blood management is based on three "pillars": detect and treat perioperative anemia; minimize perioperative blood loss; and optimize physiological tolerance of anemia [54]. Iron supplementation with or without erythropoiesisstimulating agents could increase preoperative hemoglobin levels and reduce the need for perioperative transfusions [52].…”

Prevalencia de anemia previa a cirugía cardiovascular programada y su asociación con transfusiones sanguíneas en una institución de salud en Pereira

“…La estrategia Patient Blood Management está sustentada en tres pilares: optimización del volumen eritrocitario preoperatorio, reducción de pérdida sanguínea perioperatoria y apropiada decisión de transfundir (22). Su objetivo principal es mejorar el resultado clínico y la seguridad del paciente.…”