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Recommendations for Patient Blood Management in Adults

March 20, 2019

Since blood transfusions are one of the most common and most overused procedures in developed countries, patient blood management (PBM) programs aim to protect and build up the patient’s own blood before transfusing.  The PBM International Consensus Conference met in 2018 and evaluated key areas of the PBM field, including preoperative anemia, RBC transfusion thresholds, and implementation of PBM programs. Data from 63 randomized clinical trials and 82 observational studies were analyzed. For preoperative anemia, the conference strongly recommends diagnosis and management for anemia before major elective surgery. For RBC transfusion thresholds, two strong recommendations include a transfusion threshold of <7 g/dL of hemoglobin for critically ill but clinically stable intensive care patients and a transfusion threshold of <7.5 g/dL of hemoglobin for patients undergoing cardiac surgery.  Seven additional conditional recommendations were made, including two encouraging the use of electronic or computerized support systems for the implementation of PBM programs.  The conference also highlighted the need for future research in PBM and outlined priority research recommendations to fill gaps in existing knowledge.

References:

  1. Mueller MM, Remoortel HV, Meybohm P, Aranko K, et al.  Patient blood management recommendations from the 2018 Frankfurt consensus conference.  JAMA 2019; 321(10); 983-997.  doi:10.1001/jama.2019.0554
  2. Zeller MP and RM Kaufman. Safeguarding the patient’s own blood supply.  JAMA 2019; 321(10); 943-945. 

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