As anemia is an independent risk factor associated with significant morbidity and mortality, managing perioperative anemia is critical to reduce the associated risks of bleeding and transfusions.1 Patient blood management is a multimodal approach that focuses on three goals: detecting and treating preexisting anemia, reducing the risk of intraoperative bleeding, and optimizing a patient’s physiological tolerance toward anemia.1,2
Blood management begins preoperatively to identify risk factors while treating any pre-existing anemia. Reviewing medical records and interviewing the patient before surgery helps identify risk factors for transfusion or adjuvant therapy. Preadmission labs identify any preexisting anemia which can then be treated early. The American Society of Anesthesiologists (ASA) recommends iron supplementation in patients with iron deficiency anemia and to consider erythropoietin in select populations.3 This preoperative visit should also be used to inform patients of the potential risk associated with blood transfusions, educate when to discontinue anticoagulants and antiplatelets, and discuss the option for autologous blood collection if warranted.