AFJOG

African Journal of Obstetrics and Gynaecology | Volume 2 | Issue 3 | 2024 | 37 PATIENT BLOOD MANAGEMENT Blood and blood products remain a life-saving intervention for the patient who requires a transfusion. The aim of informing the reader on Patient Blood Management (PBM) is to ensure an appropriate, step-wise, multidisciplinary approach to the management of patients so that blood and blood products are used appropriately and patient outcomes are optimised. BACKGROUND In 2010, the 63rdWorld Health Assembly adopted ResolutionWHA63.12 on A vailability, safety and quality of blood products . The Director General of the World Health Organization (WHO) was requested ‘to provide guidance, training and support to Member States on safe and rational use of blood products … and patient blood management’ . PBM remained a focus point for WHO, culminating in Strategic Objective 4 of the WHO Action Framework to Advance Universal Access to Safe, Effective and Quality Assured Blood Products 2020 – 2023 being Effective implementation of patient blood management to optimize clinical practice of transfusion. WHAT IS PBM? PBM is a multidisciplinary, patient-centric approach that aims to improve patient outcomes. PBM-based rationales should be applied to both surgical and non-surgical patients to: • Ensure the appropriate use of blood and blood products • Minimise risk • Optimise patient outcomes Any transfusion decision-making process should show cognisance of PBM principles. Despite different definitions being used for PBM, the core focus points are similar: • Timely optimisation of the patient’s own red cell mass (Note: Diagnose and treat anaemia) • Control/minimise blood loss and bleeding • Optimise and harness the patient’s physiological reserve/tolerance to anaemia • Patient empowerment and participation in the decision-making process • Multidisciplinary approach In addition, it is imperative to acknowledge the need to apply PBM principles in all phases of a patient’s treatment programme: • Pre-operative • Intra-operative • Post-operative