[WHO] THE URGENT NEED TO IMPLEMENT PATIENT BLOOD MANAGEMENT : Policy Brief
1. Introduction In the past four decades, increased awareness of the inherent risks of transfusion has resulted in major initiatives to mitigate those risks through improvements in blood component safety. The realization that the intense focus on product safety had not been matched with a similar focus on improving transfusion decisions at the bedside led to the concept of “optimal blood use”. The practice of transfusion medicine now emphasizes the judicious use of transfusion, only when clinically indicated. The concept that “our own blood is still the best thing to have in our veins” (1) has given rise to various surgical “blood conservation” techniques (for example, minimization of blood loss, blood salvage and acute isovolaemic haemodilution). Underlying these efforts is the broader concept of “patient blood management” (PBM). This is a patient-centred approach that addresses iron deficiency, anaemia, coagulopathy and blood loss, in both surgical and nonsurgical patients, as risk factors for adverse medical outcomes. Under PBM, anaemia and iron deficiency are recognized as serious global health issues in their own right, affecting billions of people worldwide. Yet, globally, there is still a gap in awareness and implementation of PBM as an overall framework to address the risks of iron deficiency, anaemia, blood loss and coagulopathy. This policy brief focuses on the urgent need to close that gap and the steps needed to achieve that goal.