IMPLEMENTING A PATIENT BLOOD MANAGEMENT PROGRAM: COMPREHENSIVE RECOMMENDATIONS AND PRACTICAL STRATEGIES

Abstract

Introduction: Blood transfusion is among the most prevalent medical interventions globally. However, contemporary scientific literature has demonstrated that the immunomodulatory effects of blood transfusion are linked to an increased risk of infection, prolonged hospital stays, and elevated morbimortality rates. Additionally, transfusions impose significant financial burdens on healthcare systems. Methods: Recognizing that blood transfusions essentially represent heterologous cell transplants, alternative therapeutic options have gained prominence, collectively referred to as the Patient Blood Management (PBM) program. PBM is a comprehensive approach founded on three core pillars: (1) optimizing the treatment of anemia and coagulopathies, particularly in the preoperative phase; (2) enhancing perioperative hemostasis and utilizing blood recovery systems to minimize patient blood loss; (3) fostering tolerance to anemia by improving oxygen delivery and reducing oxygen demand, especially in the postoperative period. Results: Current scientific evidence corroborates the efficacy of PBM in reducing the need for blood transfusions, diminishing associated complications, and promoting more efficient and safer blood management. Consequently, PBM not only enhances clinical outcomes for patients but also contributes to the economic sustainability of healthcare systems. Conclusion: This study aims to provide a comprehensive, evidence-based summary of PBM strategies through a systematic and structured model for PBM implementation in tertiary hospitals. Researchers and experts formulate the recommendations presented here from a high-complexity university hospital within the Sistema Único de Saúde network. These recommendations serve as a guideline for PBM implementation in various healthcare settings.