Patient Blood Management (PBM) is defined as a patient-centered, systematic, evidence-based approach to improve patient outcomes by managing and preserving a patient’s own blood, while promoting patient safety and empowerment.1, 2 Billions of individuals suffer from anemia – most of them unknowingly – and hundreds of millions suffer from chronic and acute blood loss and bleeding disorders or from coagulopathies.2 For decades, these conditions did not receive the appropriate attention, particularly in hospitalized patients. Accumulating evidence shows that they are independent predictors for adverse outcomes including morbidity and mortality.3, 4 Rather than diagnosing the causes of these conditions, clinicians were and still are inclined to simply prompt them with transfusion of allogeneic blood products. However, the evidence shows, that transfusion is also an independent, dose-response predictor of adverse outcomes including morbidity and mortality. In toto, this is alerting evidence and requires practice change. Therefore, the World Health Organization (WHO) has called all 194 member states to implement (PBM) as a standard of care.2 To support this call, virtually any decision maker or stakeholder within the healthcare sector must understand the sound rationale behind PBM. This includes patients, health care providers, hospital systems, the public health sector and even payers/health insurances.5, 6 The evidence is clearly in favor of PBM with case-control cohort studies, including large, population-based studies,7-14 propensity score matched analyses,15, 16 randomized controlled trials (RCTs) of the therapeutic strategies of PBM,17-21 meta-analyses and systematic reviews of therapeutic strategies of PBM,22-28 The economics are also in favor of PBM7, 11, 18, 21, 28-31. With both favorable evidence and economics, the ethical imperative for immediate PBM implementation is self-evident.
