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.
Keywords
anemia - Patient Blood Management - transfusion - blood loss - perioperative anemia
