Semin Thromb Hemost
DOI: 10.1055/s-0039-1697933
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Perioperative Anemia Management

Sandaruwani Abeysiri
1  Division of Surgery, University College London, London, England, United Kingdom
,
Marisa Chau
1  Division of Surgery, University College London, London, England, United Kingdom
,
Toby Richards
1  Division of Surgery, University College London, London, England, United Kingdom
2  Faculty of Health and Medical Sciences, University of Western Australia, Perkins South Building, Perth, Australia
› Author Affiliations
Further Information

Publication History

Publication Date:
15 October 2019 (online)

Abstract

Anemia is increasingly recognized as an interventional hematological target in patients before major surgery. Preoperative anemia increases the need for perioperative blood transfusion, and there is now a well-recognized association with increased patient complications, length of hospital stay, and worse outcomes. Patient Blood Management (PBM) is a World Health Organization endorsed, evidence-based management bundle of care in transfusion hemostasis that focuses on three main aspects: anemia management, prevention of blood loss, and appropriate transfusion practice. Implementation of PBM guidelines has been accompanied by reduced transfusion needs and improved patient outcomes. In a patient presenting with preoperative anemia or at risk of transfusion, this should initiate a program of PBM that manages the patient through the entire operative period. We review the current evidence on the three pillars of PBM and highlight those aspects with the strongest evidence in support of their impact.