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March 12, 2019

Safeguarding the Patient’s Own Blood Supply

Author Affiliations
  • 1McMaster University, Hamilton, Ontario, Canada
  • 2Canadian Blood Services, Hamilton, Ontario, Canada
  • 3Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
JAMA. 2019;321(10):943-945. doi:10.1001/jama.2019.0553

Blood transfusion is one of the most common procedures performed in hospitals in the United States and other developed countries yet is also one of the most overused.1-3 Decades of studies have attempted to define best practices for this lifesaving, costly, limited, and potentially dangerous resource. In 2005, the term patient blood management (PBM) was coined, marking a shift in focus away from blood components and toward conserving the patient’s own blood.4 Anemia, bleeding, and transfusion are independent risk factors for poor patient outcomes.3 PBM aims to improve outcomes by optimizing the patient’s red cell mass, minimizing blood loss, and limiting transfusions. All patients are eligible for blood-sparing approaches previously reserved for patients who decline transfusion, such as based on religious grounds (ie, Jehovah’s Witnesses). Medical institutions around the globe, including the World Health Organization, have adopted PBM as a standard of care.5