Perioperative blood management: Current transfusion practices and challenges

Abstract

Perioperative blood management is a crucial aspect of the care of any surgical patient. A multidisciplinary approach involving anesthesiologists, surgeons, and transfusion specialists is needed for the safe transfusion practice. It should span the entire perioperative period from preoperative evaluation until discharge from the hospital. Even though the current practice of blood management is supported by scientific research and evidence-based knowledge, many challenges still need to be addressed. Planning about blood management should start from the patient's first visit to the hospital through careful assessment and optimal preparation, including preoperative anemia management, which is found to reduce the transfusion need in the intraoperative period. It is also possible to avoid allogeneic blood transfusions by taking stringent measures to minimize intraoperative blood loss and implementing blood conservation strategies. Every institution must have a protocol for initiating and managing massive transfusions in surgical patients. Implementing a patient blood management program in every hospital can significantly contribute to accomplishing this objective. The judicious use of blood products during the perioperative phase can be ensured by establishing a blood transfusion committee, developing institutional policies, conducting routine audits, and organizing frequent training sessions.