Blood management is a comprehensive series of steps that we take preoperatively, in the operating room, and even postoperatively to manage the patient’s blood in order to avoid blood transfusion whenever possible.
The blood management strategy is individualized for every patient. This begins preoperatively by assessing the level of anemia that that patient might have and taking into consideration what operation they might need. We might be able to delay their operation in order to optimize their blood status. Intraoperatively we do a whole series of steps to try to limit blood loss and even salvage the patient’s blood. Postoperatively we also take transfusion into consideration by limiting the number of blood draws that we do and also considering that patients can often tolerate a much lower blood level than we traditionally once thought.
So many people feel that it’s simply up to the surgeon to make the decisions about the patient’s blood management. However, there’s a whole team of people who are involved in the decision beginning with the phlebotomists, the perfusionists, the anesthesiologists, and even the nurses.
At UPMC we have a center for bloodless medicine and surgery for those patients who decline transfusion. But because of the benefits we know of avoiding transfusion we apply these strategies to all patients who undergo surgery at UPMC.
Patient Blood Management and Cardiac Surgery
Chris Cook, MD, discusses the comprehensive series of steps for patient blood management.