title: The scientific basis for patient blood management.
abstract: Patient blood management is an increasingly used term to describe an evidence-based, multidisciplinary approach to optimising the care of patients who might need transfusion. It encompasses measures to avoid transfusion such as anaemia management without transfusion, cell salvage and the use of anti-fibrinolytic drugs to reduce bleeding as well as restrictive transfusion. It ensures that patients receive the optimal treatment, and that avoidable, inappropriate use of blood and blood components is reduced. This paper provides an overview of the scientific basis for patient blood management with a focus on the increasing evidence for restrictive rather than liberal transfusion practice and the use of electronic blood ordering and decision support to facilitate its implementation.
authors.affiliation: NHS Blood & Transplant, Oxford, UK; National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford University Hospitals and University of Oxford, Oxford, UK. Electronic address: mike.murphy@nhsbt.nhs.uk.
authors.forename: M F
authors.initials: MF
authors.lastname: Murphy
authors.affiliation: Stanford University, Stanford, CA, USA; Transfusion Service, Stanford University Medical Center, Stanford, CA, USA.
authors.forename: L T
authors.initials: LT
authors.lastname: Goodnough
mesh_terms: D000740:Anemia / Q000628:therapy; D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D001793:Blood Preservation / Q000592:standards; D001803:Blood Transfusion / Q000592:standards / Q000706:statistics & numerical data; D019468:Disease Management; D055695:Electronic Prescribing; D019317:Evidence-Based Medicine; D006470:Hemorrhage / Q000628:therapy; D006801:Humans; D017410:Practice Guidelines as Topic; D055656:Prescriptions; D064826:Transfusion Medicine / Q000458:organization & administration*; D065227:Transfusion Reaction; D016896:Treatment Outcome; D019564:Unnecessary Procedures
chemical_list: D000933:Antifibrinolytic Agents
keywords: Aide à la décision clinique; Blood transfusion; Blood utilisation; Clinical decision support; Dossier médicaux électroniques; Electronic medical records; La saisie des commandes médecin; L’utilisation du sang; Physician order entry; Transfusion sanguine