Patient Blood Management in Europe: surveys on top indications for red blood cell use and Patient Blood Management organization and activities in seven European university hospitals

Abstract

Although the seven hospitals provide a similar range of clinical services, there was variation in transfusion rates between them. Further, there was variable implementation of PBM activities and monitoring of transfusion practice. These findings provide a baseline to develop joint action plans to further implement and strengthen PBM across a number of hospitals in Europe.

Patient Blood Management initiatives on a global level: the results of an International Society of Blood Transfusion Survey

“…The results of this survey provide an overview of PBM initiatives on a global level. To date, most data on the implementation of PBM has been collected in the Western world . In the current survey, the majority of responses came from respondents who worked in large and university hospitals, which was reflected in the large numbers of RBCs, platelets and plasma used in the majority of responding hospitals.…”

“…In a survey among AABB members, 38% of the respondents indicated to have a formal PBM program installed; however, the nature, number and extent of the programs that had been implemented were not described . The Patient Blood management in Europe (PaBloE) survey of the European Blood Alliance reported different rates of PBM activities among seven European hospitals .…”

Towards a systematic approach for (de)implementation of patient blood management strategies

“…Despite the increasing availability of knowledge and evidence generated by scientific research, this knowledge and evidence does not automatically find its way into daily practice. This is also applicable to the field of transfusion medicine, including the field of Patient Blood Management (PBM) (Lorencatto et al, ; Bruun et al, ; So‐Osman et al, ). This may either involve the lack of implementation of new, improved, better or cheaper diagnostic tools, treatments and guidelines, or it may apply to the use or overuse of tools and treatments that have proven to be of limited benefit for patients, may potentially increase costs and may even cause harmful effects.…”

“…However, no information or recommendations are provided on how to implement these elements in practice. Several studies describe the current status of implementation of PBM and conclude that there are major differences between hospitals internationally and that major deficits occur in both high-and middle-and low-income countries regarding the current implementation status of all PBM activities of the three pillars despite educational efforts (Spahn et al, 2013;Baron et al, 2016;Bruun et al, 2016;Eichbaum et al, 2016; Van der Linden (De)Implementation of PBM strategies 161 & Hardy, 2016; Darbandi et al, 2017;So-Osman et al, 2017). Challenges to bridge the gap between evidence and clinical practice, mentioned in literature, include organisational problems such as inadequately skilled workers, poor financing and the lack of voluntary non-remunerated blood donors, especially in lower-income countries (Baron et al, 2016, Bruun et al, 2016, Eichbaum et al, 2016, Van der Linden & Hardy, 2016, Darbandi et al, 2017, So-Osman et al, 2017.…”

Current approaches to increase blood donations in resource‐limited countries

“…These indications benefit from whole‐blood transfusion that is cheap and easy to prepare. In developed countries, blood components (but not whole blood) are the blood products available to top up an elderly population with moderate anaemia and those receiving chemotherapies for cancer, and relatively few are used for severe bleeding or anaemia (Bruun et al, ). The issues regarding the conceptual and cultural diversity surrounding blood and blood donation in LMICs, as opposed to HICs, has been well summarised by Mumtaz et al .…”