Patient Blood Management: Effectiveness and Future Potential

Before major surgery, 30 to 40% of patients are anemic, an important consideration that is associated with increased erythrocyte transfusions, prolonged hospital length of stay, more frequent intensive care admissions, infections, and thromboembolic events, and mortality. Surgical bleeding contributes to anemia, increases transfusions, and independently increases mortality.  In addition, transfusion of allogeneic blood products is associated with increased morbidity and mortality and increased costs, and allogeneic blood products are a limited resource.  Therefore, as a pragmatic solution, the concept of Patient Blood Management was developed and published in its preliminary form, first in the anesthesia literature as an editorial in Anesthesiology in 2008.  The authors hypothesized that “Patient Blood Management will decrease the use of allogeneic erythrocyte transfusion and its cost and adverse sequelae significantly.” Currently, 12 yr later, we can conclude this is indeed the case.