Connect Sign InWhat Is Patient Blood Management and Where Do We Go From Here?
The Joint Commission and the American Medical Association (AMA) identified blood transfusions as one of the five most overused interventions in healthcare, and at a 2012 National Summit on Overuse, issued a call to reduce blood transfusions. The variability in the use in cardiovascular surgery, for example, illustrates an inappropriate use of blood components in coronary artery bypass grafts (CABGs). Accordingly, patient blood management (PBM) programs developed initiatives to optimize erythropoiesis, minimize blood loss, and manage anemias in the surgical setting: preoperatively, intraoperatively, and postoperatively. A general therapeutic principle in PBM is to avoid empiric thresholds for red blood cell (RBC) transfusion; and to administer transfusion on a unit-by-unit basis, according to patient symptoms. Choosing Wisely campaigns by medical societies as well as guidelines/recommendations for RBC transfusions have resulted in substantial reductions in RBC utilization, not only at individual medical centers, but also at the national and international levels. PBM has demonstrated that with improved patient safety (reduced exposure to transfusions), health care costs are also reduced. PBM now represents best practices and the standard of care.
Lawrence Tim Goodnough, MD is professor of pathology and medicine in the Departments of Pathology and Medicine at Stanford University, and he is the director of the Transfusion Medicine Fellowship Program.
Dr. Goodnough received his medical degree in 1975 from the University of Pennsylvania, completed an internship and residency in Internal Medicine at the University of Alabama Hospitals in Birmingham, Alabama, and a fellowship in Hematology/Oncology at Case Western Reserve University. He is board certified in medicine, hematology, and oncology; and has an American College of Pathology certification in blood banking.
As a frequent lecturer, he has presented his work in more than 300 national and international forums. Dr. Goodnough has contributed more than 500 articles and 200 abstracts to the medical literature. He has a long-standing interest in devising strategies for patients to utilize alternatives to blood transfusion for management of anemia, a concept more recently defined as PBM.
