Overcoming Patient Blood Management Barriers in Low- and Medium- Income Countries: Starting Small to Stand Tall

Abstract

Although being essential in several clinical and surgical contexts, the transfusion of blood components is not considered a risk-free approach or an abundantly available resource, becoming imperative to establish judicious transfusion decisions, based not only on medical purposes, but also on economic grounds and the estimated cost of the entire chain of blood components. It was in this context that Patient Blood Management (PBM) programmes emerged, a patient-centered bundle of care, upon which decisions are taken from a multidisciplinary, systematized and evidence-based vision, optimizing treatment, prognosis and the use of resources. Notwithstanding that PBM pillars are universally applicable, regional differences require thorough scrutiny on how they can be effectively met, considering local reality, its potentials and challenges. Healthcare providers and funders, professional medical societies and scholars, each of them in their limited scale, are the main advocates for PBM implementation, by creating local-adapted, pilot guidelines and algorithms, with whatever tools and resources available, that will permit the first kickoff to set up PBM as the standard of care, personalized to the reality of each society or institution.