Patient Blood Management: Optimizing Transfusion Benefits and Recognizing When Transfusions Are Helpful

For each of these basic principles there are several strategies that may be employed to promote PBM: • Prepare and manage a patient, whenever possible, so that transfusion thresholds are less likely to be approached. This includes assessing the patient for anemia prior to elective surgery and taking steps to correct the problem. • Reduce blood loss through use of certain pharmaceuticals such as tranexamic acid (TXA) in orthopedic surgery; use meticulous surgical techniques and minimize the frequency of laboratory testing and amount of blood collected for lab tests. • Manage the patient so that the physiologic impact of the anemia (that is, reduction in the red blood cell count) or other abnormality is minimized. If a transfusion is needed, make transfusion decisions based on the best available, objective evidence.