Perioperative Anemia, Transfusion Practices, and Patient Blood Management: Lessons from the COVID-19 Pandemic

Area of Science:

• Anesthesiology
• Hematology
• Surgical Care

Background:

• The COVID-19 pandemic revealed global blood supply fragility.
• Perioperative anemia is linked to poor surgical outcomes and often treated with allogeneic blood transfusion (ABT), posing risks.
• Iron deficiency is a primary, correctable cause of perioperative anemia.

Purpose of the Study:

• To review perioperative anemia management strategies.
• To explore methods for minimizing ABT reliance within patient blood management (PBM).
• To highlight PBM's role in enhancing transfusion safety and sustainability.

Main Methods:

• Narrative review of existing literature on perioperative anemia.
• Examination of PBM principles and transfusion alternatives.
• Analysis of evidence supporting various anemia treatment modalities.

Main Results:

• Iron therapy, erythropoiesis-stimulating agents, antifibrinolytics, and blood conservation techniques can decrease transfusion needs.
• PBM strategies are effective in reducing allogeneic blood transfusion (ABT) requirements.
• Evidence supports improved clinical outcomes with PBM implementation.

Conclusions:

• Patient blood management (PBM) offers a framework to improve transfusion safety and sustainability.
• Implementing PBM can enhance patient outcomes and conserve vital blood resources.
• Minimizing allogeneic blood transfusion (ABT) is crucial for patient safety and resource management.