By Brontë H. Lacsamana, Reporter
PATIENTS with anemia, iron deficiency, or other conditions that may require blood transfusion will benefit more from hospitals that practice patient blood management (PBM), which optimizes patient outcomes through the preservation of their blood, hematology experts said.
“Sure, there are patients who will eventually need transfusion, but even for them there are still guidelines to facilitate diagnosis so as not to miss the treatment options before transfusion,” said Dr. Jesus A. Relos, Makati Medical Center’s (MMC) hematology section chief, at a Nov. 15 webinar held by the Philippine College of Physicians.
“Under PBM, anemia and iron deficiency are recognized as global health issues in their own right and addressed with the utmost care and consideration,” he added.
The World Health Organization (WHO) estimates that about 42% of children under 5 years old and 40% of pregnant women are anemic.
In the Philippines, iron deficiency is prevalent yet overlooked, with the main cause being nutritional, said Dr. Relos. The next most common cause is inflammation from infections like tuberculosis, malaria, and coronavirus disease 2019 (COVID-19).
“Physicians should really engage in close monitoring of anemic patients,” he said.
NEW STANDARD OF CARE
PBM will help avoid unnecessary transfusions, which expose patients to transmissible infections and the risk of adverse reactions, the WHO said in a 2021 policy brief.
Recommended strategies include maximizing the capacity of the patient to tolerate anemia and implementing guidelines for rational blood use.
In June, the Philippine Red Cross collected 166,266 blood units from January to end of June this year, slightly less than the 218,578 blood units collected in the same period last year but still more than in 2020, when the pandemic first hit.
The blood shortage that the world has been facing is a sign that PBM must now become the prevailing standard of care, said Dr. Ma. Angelina L. Mirasol, clinical associate professor at the University of the Philippines-Philippine General Hospital (UP-PGH).
“We must practice it because there’s overwhelming scientific evidence that it reduces mortality and morbidity, shortens hospital stays, and lowers costs. We also have an ethical obligation not to ignore and withhold such a beneficial medical model,” she said.
Aside from PBM programs now in place in hospitals like MMC and UP-PGH, Dr. Mirasol pointed out that Republic Act No. 7719, or the National Blood Services Act of 1994, already mandates rational blood use.
Dr. Relos agreed, saying that many medical professionals are already in keeping with the principles of PBM. “Hospitals just need to formalize it, even if not labeled as PBM, as long as we know the pillars and get the right outcomes,” he added.