title: [Patient blood management].
abstract: OBJECTIVE
  In a context of regular review of transfusion practice, the aim of this review is to present an update of the scientific basis of the so-called "patient blood management" (PBM), the state of its development in Europe, and possible ways to progress its development further in France.
  
  
  METHODS
  Analysis and synthesis of the data from scientific literature on the scientific basis of PBM (methods, indications, efficacy, risks, efficiency).
  
  
  RESULTS
  PBM appears as an evidence-based, patient centred, multidisciplinary approach, aiming to optimise the care of patients who might need transfusion and, consequently, the use of blood products. PBM is based on three pillars: optimise the patient's own blood supplies, minimise blood loss, optimise patient's tolerance of anaemia. Available scientific evidence can be considered as sufficient to consider PBM guidelines and practices as an indispensable complement to the transfusion medicine guidelines and practices. Several countries have launched PBM programmes (alternatives to allogeneic transfusion and optimisation of the use of blood components). Although current French national transfusion guidelines contain some PBM measures, PBM programmes should be further developed in France, primarily for medical reasons.
  
  
  CONCLUSIONS
  Possible ways, using the existing basis having proved to be effective, are proposed to further develop PBM in France, as a complement to transfusion medicine, with the participation of involved stakeholders, including experts from relevant medical specialties, both at local and national levels.
authors.affiliation: Établissement français du sang (EFS), 20, avenue du Stade-de-France, 93218 La-Plaine-Saint-Denis, France. Electronic address: gilles.follea@efs.sante.fr.
authors.forename: G
authors.initials: G
authors.lastname: Folléa
mesh_terms: D000740:Anemia / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy; D016913:Blood Component Transfusion / Q000706:statistics & numerical data; D001803:Blood Transfusion / Q000706:statistics & numerical data; D001804:Blood Transfusion, Autologous; D005060:Europe; D005602:France; D006397:Hematinics / Q000627:therapeutic use; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007501:Iron / Q000627:therapeutic use; D015201:Meta-Analysis as Topic; D010348:Patient Care Team; D010353:Patient Education as Topic; D018802:Patient-Centered Care / Q000458:organization & administration* / Q000592:standards; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D064826:Transfusion Medicine / Q000458:organization & administration* / Q000592:standards
chemical_list: D006397:Hematinics; D006454:Hemoglobins; D007501:Iron
keywords: Blood components; Blood transfusion; Gestion du sang du patient; Médecine transfusionnelle; Patient blood management; Produits sanguins labiles; Public healthcare; Santé publique; Transfusion medicine; Transfusion sanguine