Anaesthetic considerations for patient blood management in cancer surgery: a narrative review

Anaemia is a common and constant challenge in oncology. Many patients treated for cancer suffer from undiagnosed and untreated anaemia and may receive unnecessary blood transfusions, despite existing guidelines. Transfusion can lead to increased morbidity and mortality, longer hospital stays, and higher costs, all in a dose-dependent manner. Patient Blood Management (PBM) is founded on three key pillars: managing anaemia, reducing blood loss, and improving tolerance to anaemia. These strategies should be implemented before, during, and after surgery. PBM programmes have proven to be effective in lowering transfusion rates and should be applied to every patient undergoing cancer-related surgery. As a standard of care, PBM could significantly enhance patient safety and long-term outcomes in a multidisciplinary surgical and medical oncology context. However, adherence to these recommendations remains insufficient. Key considerations during cancer surgery include: 1. Preoperative detection of anaemia and iron deficiency (ferritin <100 µg/L and/or Show more