Patient Blood Management Program Implementation: Comprehensive Recommendations and Practical Strategies
Year: 2024
Type: article
Abstract: INTRODUCTION: Blood transfusion is one of the most common medical practices worldwide. However, current scientific literature has shown that the immunomodulatory effects of blood transfusion are associated with an increased likelihood of infection, prolonged hospitalization, and morbimortality. Also, it means high costs for healthcare systems. METHODS: In this context, acknowledging that blood transfusions are essentially heterologous cell transplantations, the use of therapeutic options has gained strength and is collectively known as the patient blood management (PBM) program. PBM is an approach based on three main pillars: (1) treating anemias and coagulopathies in an optimized manner, especially in the preoperative period; (2) optimizing perioperative hemostasis and the use of blood recovery systems to avoid the loss of the patient's blood; (3) anemia tolerance, with improved oxygen delivery and reduced oxygen demand, particularly in the postoperative period. RESULTS: Current scientific evidence supports the effectiveness of PBM by reducing the need for blood transfusions, decreasing associated complications, and promoting more efficient and safer blood management. Thus, PBM not only improves clinical outcomes for patients but also contributes to the economic sustainability of healthcare systems. CONCLUSION: The aim of this review was to summarize PBM strategies in a comprehensive, evidence-based approach through a systematic and structured model for PBM implementation in tertiary hospitals. The recommendations proposed herein are from researchers and experts of a high-complexity university hospital in the network of the Sistema Único de Saúde, presenting itself as a strategy that can be followed as a guideline for PBM implementation in other settings.
Authors: Isabel Cristina Céspedes, Maria Stella Figueiredo, Nelson Americo Hossne Junior, Ítalo Capraro Suriano, Rita de Cássia Rodrigues, Melca Maria Oliveira Barros, Manoel Antonio de Paiva Neto, Fernanda Chohfi Atallah, Bárbara Burza Benini, Adriano Miziara Gonzalez, Fábio Veiga de Castro Sparapani, Newton de Barros Júnior, Ieda Aparecida Carneiro, Celina Mayumi Morita Sarto, Caio Sussumu de Macedo Motoyama, Leonardo Sacchi, Victor Piovezan, Simone Luna de Almeida, Laís da Silva Pereira-Rufino, Solange Guizilini, Isadora Salvador Rocco, Nacime Salomão Mansur, Jaquelina Sonoe Ota Arakaki, Antonio Alceu dos Santos, Carlos Eduardo Panfilio
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4401307997