Comprehensive Patient Blood Management
Hospitals across the U.S. are over-transfusing.
There are published studies that suggest up to 40 to 60 percent of all blood transfusions are unnecessary or even avoidable.1 Blood transfusion is one of the most common medical procedures. Yet, growing evidence continues to associate transfusion with a higher incidence of infections, renal injury, pulmonary injury, myocardial infarction, and mortality. Background In the past five years there has been an explosive growth in interest in what has come to be known as Patient Blood Management (PBM). Central to PBM is elimination of unnecessary, inappropriate and avoidable transfusions recognizing that transfusion is an inherently high risk medical procedure.
Since 1999 and the landmark TRICC Trial (Hebert PC, et al. New England Journal of Medicine 1999,340-409-417) the following questions are increasingly being asked and to some degree, answered:
- Are the majority of transfusions avoidable?
- Are transfusion decisions evidence-based or simply a result of practice habits and medical conventions that are outdated given recent studies?
- What are tolerable lower limits for hemoglobin concentrations and safe anemia thresholds? Are outcomes better or worse when hemodynamically stable patients are transfused?
- What are the competing strategies to transfusions, their limitations and cost effectiveness?