Patient blood management to reduce surgical risk

Area of Science:

• Anesthesiology
• Surgical Care
• Hematology

Background:

• Preoperative anemia and perioperative blood transfusion are significant, preventable surgical risks.
• Patient blood management (PBM) is a multimodal strategy addressing these risks.
• PBM focuses on treating anemia, reducing blood loss, and optimizing patient reserves.

Purpose of the Study:

• To review the necessity of PBM in surgical pathways.
• To outline strategies for PBM implementation.

Main Methods:

• Literature search of studies on PBM's three pillars using PubMed.
• Focus on recent evidence-based guidance for perioperative management.

Main Results:

• Anemia is prevalent in surgical patients, independently linked to adverse outcomes.
• Intravenous iron is recommended for functional iron deficiency; tranexamic acid and cell salvage reduce intraoperative blood loss.
• Restrictive transfusion practices are the standard of care post-surgery.

Conclusions:

• Preoperative anemia is often underappreciated and requires routine investigation and treatment.
• The risks of unnecessary blood transfusions are increasingly recognized.
• Adopting PBM in surgical practice is recommended to reduce costs and enhance patient outcomes.