Patient blood management

Patient blood management (PBM) is a multidisciplinary, evidence-based approach to optimizing the care of patients who might need a blood transfusion. PBM aims to improve patient outcomes by managing and preserving a patient's own blood, minimizing blood loss, and enhancing the patient's tolerance of anemia.

Principles of Patient Blood Management

PBM is based on three main principles:

1. **Optimizing red blood cell mass**: This involves diagnosing and treating anemia, optimizing erythropoiesis, and ensuring adequate iron stores.
2. **Minimizing blood loss and bleeding**: Techniques include meticulous surgical techniques, the use of antifibrinolytics, and minimizing iatrogenic blood loss.
3. **Enhancing tolerance of anemia**: Strategies include optimizing oxygen delivery and utilization, and employing restrictive transfusion thresholds.

Techniques and Strategies

PBM employs various techniques and strategies, including:

• **Preoperative optimization**: Identifying and treating anemia before surgery.
• **Intraoperative blood conservation**: Using cell salvage, minimizing blood draws, and employing surgical techniques that reduce blood loss.
• **Postoperative management**: Monitoring and managing anemia, and using restrictive transfusion practices.

Benefits of Patient Blood Management

The benefits of PBM include:

• Reduced need for allogeneic blood transfusions.
• Lower risk of transfusion-related complications.
• Improved patient outcomes, including reduced morbidity and mortality.
• Cost savings for healthcare systems.

Implementation

Successful implementation of PBM requires a coordinated effort among various healthcare professionals, including surgeons, anesthesiologists, hematologists, and nurses. It also involves the use of clinical guidelines and protocols, education and training, and continuous quality improvement initiatives.

Related Pages

• Blood transfusion
• Anemia
• Erythropoiesis
• Surgery
• Hematology
• Anesthesiology