Anemia and Blood Management

Preoperative anemia is a major risk factor for all-cause morbidity and mortality. Blood transfusion does not mitigate these risks. Therefore all patients should be screened and have their anemia treated when possible prior to a major surgery. Newer intravenous iron preparations are safe and effective and can be used on an outpatient basis. All patients should have a restrictive blood transfusion strategy. Surgical technique, the use of anti-fibrinolytics, and cell salvage can help reduce blood transfusion during surgery.