E-Book

E-Book 3rd Congress

  • Implementation of PBM in dealing with blood crises during surgery
  • Motahareh Sadeghi,1,* Younes Sadeghi bojd,2
    1. Student research committee, school of Allied medical science, zahedan university of medical science, zahedan, Iran
    2. Department of Laboratory Sciences, School of Allied Medical Sciences, Zahedan University of Medical Sciences, Zahedan, Iran


  • Introduction: Preoperative anaemia and perioperative blood transfusion are both identifiable and preventable surgical risks. Patient blood management is a multimodal approach to address this issue Patient blood management (PBM) is defined as the application of evidence-based diagnostic, preventive and therapeutic approaches designed to maintain hemoglobin concentration, optimize hemostasis and minimize blood loss to improve patient outcomes. We propose a protocol for the assessment of the evidence of diagnostic, preventive, and therapeutic approaches for the management of relevant outcomes in surgery of patients to create a framework for PBM implementation.
  • Methods: Medline databases (PubMed, EMBASE, Web of Science, and CINAHL) were searched from 2018 to 2023.
  • Results: Forty-nine publications matching the selection criteria and reporting results in the predefined areas were included in the final analysis. Pre-operative anemia, even if mild, in patients who are candidates for major surgery (not cardiac) is independently associated with a higher risk of morbidity and mortality at 30 days24. Furthermore, a recent, retrospective study demonstrated that, in the peri-operative period of patients undergoing heart surgery, the sum of two risk factors, that is anemia (hematocrit <25%) and transfusion therapy with red cell concentrates, had a greater, and statistically significant, effect on post-operative morbidity and mortality25. Anemia is, therefore, a contraindication to performing elective surgery.
  • Conclusion: progress in the identification and implementation of best transfusion practices based on evidence-based systematic reviews suggests that, compared with a liberal allogenic blood transfusion policy, there was no evidence of negative consequences when following a restrictive blood transfusion policy. As PBM is being increasingly introduced in routine clinical practice, there is wide expectation that it will shape the practice of transfusion medicine, the modality of prescription, preparation, and administration of blood components as well as the relationship between different disciplines. PBM brings a paradigm shift in the concept of blood components which should be considered not only an important resource but also a possible risk factor, with increases in costs, a sometimes-limited availability: risky, costly, in limited supply, and their use can worsen negative patient outcomes. PBM aims to overcome the ‘product-centered’ concept of blood components and to have a ‘patient-centered’ approach that focuses on improving the health and well-being of the patient.
  • Keywords: patient blood management, blood transfusion, therapeutic, General Surgery