Error traps in Pediatric Patient Blood Management in the Perioperative Period

Abstract

Pediatric patients with severe anemia, coagulopathy or clinically significant blood loss are frequently encountered in the perioperative environment. Appropriate management is most effective and safest when harnessing the patient's own hematopoietic system if time permits. In some situations, allogeneic blood component transfusion is necessary to preserve limb and/or life. While necessary to treat anemia, clotting disorders, or improve oxygen delivery, allogeneic blood transfusions can place pediatric patients at risk for respiratory complications, infection, alloimmunization, prolonged hospital stays, multi-organ failure, and death. 1 Therefore, finding ways to reduce unnecessary allogeneic blood transfusions may improve pediatric patient outcomes.Patient Blood Management (PBM) is a patient-centered, systematic, evidence-based approach to improve patient outcomes by managing and preserving the patient's own blood, while promoting patient safety and empowerment. 2 In adult surgical patients, PBM has reduced overall transfusions, hospital costs, and adverse events.PBM is a new standard of care to optimize blood health. 3 This report focuses on providing insight and guidance to the pediatric anesthesiologists regarding evidence-based recommended clinical care considerations for pediatric PBM (pPBM).