[Patient Blood Management in Clinical Practice: A Multimodal Perioperative Approach]

Patient Blood Management (PBM) is an evidence-based, multimodal approach to improve patient safety, reduce avoidable allogeneic blood transfusions, and preserve limited blood resources. A central component is the early detection and treatment of preoperative anemia, an independent risk factor for perioperative mortality, increased transfusion rates, and prolonged hospital stays.At Charité - University Medicine Berlin, a standardized PBM pathway integrates anemia screening into the preoperative assessment of patients with a relevant risk of bleeding and transfusion. Patients with anemia undergo further diagnostic evaluation followed by cause-specific treatment, particularly with intravenous iron, erythropoietin, or a combination of both. Treatment success is assessed by repeat hemoglobin measurement prior to surgery.Additional PBM measures include the targeted use of intraoperative cell salvage, standardized assessment of individual bleeding risk, and risk-adapted perioperative management of anticoagulant and antiplatelet therapy. Together, these measures provide a structured, interdisciplinary approach to reducing perioperative blood loss and transfusion requirements while improving patient safety.