Patient blood management
Patient blood management (PBM) is the application of evidence based medical and surgical practices designed to prevent anaemia and decrease bleeding. PBM aims to identify patients at risk of transfusion and provide a management plan aimed at reducing this need and improve patient outcomes. Multiple strategies can be employed which fall broadly into three categories referred to as the ‘three pillars’ of PBM:
- anaemia management to optimise the red cell mass
- minimisation of blood loss
- tolerance of anaemia (only transfusing when clinically required and optimising the patient’s physiological tolerance of anaemia).
In elective surgery PBM activities include:
- pre-operative work-up (assessment and treatment of anaemia);
- intra-operative surgical, anaesthetic, technological and pharmacological strategies; and
- post-operative blood conservation and supportive care.
See about patient blood management (PDF 196KB) for more information on the three pillars, and PBM in general.
National PBM Guidelines
In Australia, adoption of a PBM approach is being supported by the production of six clinically focused, evidence based national PBM guidelines:
- critical bleeding/massive transfusion (module 1)
- perioperative (module 2)
- medical (module 3)
- critical care (module 4)
- obstetrics and maternity (module 5)
- neonatal and paediatrics (module 6)
These guidelines, which are gradually being introduced, provide recommendations on the most appropriate clinical use of transfusion and alternate strategies and therapies.
Further information is available from the National Blood Authority's website.
For more information on patient blood management activities in SA, contact Blood, Organ and Tissue Programs on (08) 8463 6197.