Patient Blood Management

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The Patient Blood Management (PBM) (English) provides an individual treatment plan for the reduction and prevention of anemia and blood loss as well as the rational use of blood products is.

PBM is a clinical, multidisciplinary, patient-centered concept that primarily includes treating or preventing anemia, reducing blood loss and increasing anemia tolerance. The transfusion of allogeneic blood products is only considered after these therapeutic possibilities have been exhausted . Unlike the EU- initiated Optimal Blood Use Project (EUOBUP), which aims to administer the right blood product to the right patient at the right time, the PBM goes one step further and tries to have a preventive and corrective influence on those risk factors that are usually lead to transfusions. The application of the PBM concept is indicated not only for the perioperative phase, but also for all areas of medicine that deal with the treatment with blood and blood products. The primary goal of the PBM is to improve the patient's outcome .

Origin of Patient Blood Management

PBM was developed using data from the first Austrian benchmark study together with international experts and is now being implemented in Western Australia and in a number of American and European centers. It was included in the WHO agenda and on the homepage of the American Association of Blood Banks (AABB) in 2010 as an important principle for improving transfusion safety .

Objectives of Patient Blood Management

In addition to the preoperative treatment of anemia and the improved use of erythrocyte concentrates in the event of a transfusion, as well as the minimization of diagnostic and interventional blood loss, one of the goals of the PBM is the avoidance and treatment of coagulation disorders and thus a patient-oriented use of coagulation preparations and platelet concentrates to establish.

The following 3 main treatment pillars are at the center of the PBM project:

1. Optimization before surgery
  • Detection of anemia
  • If the patient is anemia, present the patient in an interdisciplinary manner
  • Treat the anemia before surgery if justifiable
2. Rational use of blood reserves
  • Strict application of the cross-sectional guideline of the German Medical Association
3. Measures to save foreign blood
  • Reluctant to take blood samples
  • Use of tourniquet during surgery
  • Reprocessing of wound blood during surgery (cell saver devices)
  • Coagulation treatment close to the patient (point-of-care such as thrombelastometry or impedance aggregometry)

further reading

  • Malte Oehlschläger: Patient Blood Management as a medical standard - in the light of law and case law. In: Anaesthesiology & Intensive Care Medicine. Volume 60, December 2019, pp. 572-576.

Web links

  • Website of patient blood management

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  1. ^ Hans Gombotz, Kai D Zacharowski, Donat Spahn: Patient Blood Management. Thieme Verlag, Stuttgart 2013, ISBN 978-3-131-70621-8 .
  2. ↑ Optimal Blood Use Project (EUOBUP)
  3. ↑ Patient-Blood-Management doctors newspaper
  4. ↑ PBM Western Australia on health.wa.gov.au
  5. ↑ WHO: sixty third World Health Assembly Geneva, WHA 63.12 (May 21, 2010, PDF)
  6. ↑ American Association of Blood Banks (AABB) ( Memento of the original from February 28, 2014 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. on aabb.org @1@ 2Template: Webachiv / IABot / www.aabb.org
  7. ↑ Deutsches Ärzteblatt August 5, 2013: "Patient Blood Management: Smart Use of a Valuable Resource" [1]