Current Environment:

Patient Blood Management (PBM)

Patient Blood Management (PBM) is a new standard of care to promote pediatric blood health in the perioperative period and beyond. It encompasses a multimodal and multidisciplinary strategy that aims to improve clinical outcomes by using blood conservation strategies to preserve the patient’s own blood, manage anemia, control bleeding, and avoid unnecessary exposure to blood components.

Over the past decade, pediatric PBM has evolved to include additional evidence-based tools (including preoperative anemia management), antifibrinolytics, cell salvage, massive hemorrhage protocols, physiologically driven individualized goal directed transfusion algorithms, improved point-of-care and viscoelastic testing, as well as further recognition of the risks, cost, and stewardship associated with allogeneic blood transfusion.

Our department has harnessed the power of data and designed a contemporary PBM perioperative database and interactive dashboard. It currently contains more than 125,000 de-identified patients who underwent non-cardiac surgery at Boston Children's in the last five years. It displays a multitude of patient metrics from intraoperative blood products given to occurrences of postoperative complications. This dashboard is unique in that it serves as a quality dashboard and a clinical dashboard to benchmark and track patient-centered outcomes for those children at risk for bleeding and transfusion in the perioperative setting. These data will be used to:

  • define metrics pertaining to anemic and bleeding patients
  • measure trends in blood transfusion metrics
  • compare outcomes in transfused vs non-transfused cohorts
  • rrack specific patient blood management blood management modalities and quality improvement initiatives
  • educate providers, find opportunities to guide best evidence-based patient care
  • track quality improvements initiatives, patient outcomes, better allocate blood product resources, and reduce costs

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