What is Patient Blood Management (PBM)?
The PBM is a multidisciplinary approach consisting of a bundle of measures aiming at improving treatment success for patients undergoing elective surgery.1 It deals with three risk factors that have a negative impact on treatment outcomes: preoperative anaemia, blood loss, and the overuse of blood transfusions
The core measures of PBM focus on the treatment of anaemia prior to surgery,2, 3, 4 , 5, 6 the reduction of bleeding, and the appropriate use of blood products.7
By introducing PBM measures, treatment outcomes can be improved significantly, and costs can be reduced at the same time. Benefits from this accrue to patients, hospitals and the health care system as a whole. This has been demonstrated in numerous studies.8, 9, 10, 11
PBM measures also contribute to improving the safe provision of blood products,7 so that these products can be used in cases where they save lives. Due to demographic change,12 decreases in blood donations, and the overuse of blood products, the WHO estimates that from about 2030 there will be global shortages,13 while shortages in Switzerland are already expected from 2022.14
- Munoz M, et al. «Fit to fly»: overcoming barriers to preoperative haemoglobin optimization in surgical patients. Br J Anaesth 2015;115:15–24.
- Musallam KM, et al. Preoperative anemia and postoperative outcomes in non-cardiac surgery: a retrospective cohort study. Lancet 2011;378:1396–1407.
- Kotzé A, et al. Effect of a patient blood management programme on preoperative anemia, transfusion rate, and outcome after primary hip or knee arthroplasty: a quality improvement cycle. Br J Anaesth 2012;108:943–952.
- Clevenger B, Richards T. Pre-operative anemia. Anaesthesia 2015;70:20–28.
- Beattie WS, et al. Risk associated with preoperative anemia in noncardiac surgery: a single-center cohort study. Anesthesiology 2009;110:574–581.
- Spahn DR, et al. Non-treatment of preoperative anemia is substandard clinical practice. Br J Anesthesia 2015;115:1–3.
- Farmer SL, et al. Programmatic Approach to Patient Blood Management – Reducing Transfusions and Improving Patient Outcomes, The Open Anesthesiology. Journal 2015;9:6–16.
- Mehra T, et al. Implementation of a patient blood management monitoring and feedback program significantly reduces transfusions and costs. Transfusion 2015; Dec;55(12):2807-15
- Leahy MF, et al. Improved outcomes and reduced costs associated with a health-system-wide patient blood management program: a retrospective observational study in four major adult tertiary-care hospitals. Transfusion.2017;57(6):1347–1358.
- Meybohm P, et al. Patient Blood Management is Associated With a Substantial Reduction of Red Blood Cell Utilization and Safe for Patient’s Outcome: A Prospective, Multicenter Cohort Study With a Noninferiority Design. Ann Surg 2016;264(2):203–211.
- Greinacher A, Fendrich K, Hoffmann W. Demographic Changes: The Impact for Safe Blood Supply. Transfus Med Hemother 2010;37(3):141–148.
- WHO 2010, 63rd assembly A63/20; WHO resolution WHA63.12. Availability, safety and quality of blood products.
- Volken T, Schenk D. Versorgung mit Blut und Blutprodukten in der Schweiz. Auswertung der Blutentnahmen und Bluttransfusionen im Zeitraum zwischen 1996 und 2013 mit einer Projektion bis 2035, Schlussbericht. Forschungsstelle Gesundheitswissenschaften, ZHAW Zürcher Hochschule für Angewandte Wissenschaften, ZHAW Forschungsbericht.
- PBM Exigo App (available for free from the iOS App Store /Google Play Store)