Iron Therapy: A Piece in the Puzzle of Allogeneic Blood Saving Strategies
Recently, the combination of increasing costs for the provisions of blood products1, increasing recognition of the risks associated with transfusion and growing awareness of the possible future shortage of blood supply has raised the interest of the scientific community in the concept of “blood management”2.
Blood management should not be confused with the concept of bloodless medicine, which is a programmatic approach to dealing with a small subset of patients who refuse blood transfusions3.
Patients’ blood management is “the timely application of evidence-based medical and surgical concepts designed to maintain haemoglobin concentration, optimise haemostasis and minimise blood loss in an effort to improve patient outcome”4. The principle at the basis of this concept is the improvement of patients’ outcome through the integration of all available techniques to ensure safety, availability, and appropriate allocation of blood products5.
This new strategy covers the whole peri-operative period and is characterised by a patient-specific multidisciplinary and multifaceted team approach which entails a partnership between transfusion medicine specialists and the many different health care specialists who interact with the blood bank1,6.
It does, therefore, represent “a model of multidisciplinary care where the changes in culture are system directed on the basis of evidence-based medicine”, as stated by Kumar and colleagues5. It also includes the appropriate provision of blood components in compliance with transfusion guidelines and suggests alternatives when they are appropriate1.
