Patient blood management

Patient blood management (PBM) refers to “the appropriate use of blood and blood components, with a goal of minimizing their use” (Goodnough and Shander, Anesthesiology 116: 1367-1376, 2012). In short, PBM is conservative transfusion practice, and its prioritization stems from the increased recognition of transfusion-associated risk, evidence of favorable outcomes with restrictive transfusion practice, and-importantly-a drive toward cost containment. When applied thoughtfully, PBM saves cost and improves clinical outcomes. The following chapter provides an overview of PBM, from steps toward implementation to description of the individual measures within the PBM framework. The latter include policy and clinical guidelines, personnel and organizational oversight, perioperative interventions, information technology, and specialized products/processes. Each has its own advantages and disadvantages, and implementation should be tailored to the specific institutional needs given limited resources and human capacity. Foremost, successful implementation relies on executive support and interdisciplinary cooperation. Even with modest investment, PBM offers wide-ranging benefits and conserves a limited resource.