Integrated strategies for allogeneic blood saving in major elective surgery

Ferric carboxymaltose with or without erythropoietin in anemic patients with hip fracture: a randomized clinical trial

“…Additionally, RBC transfusions are not without complications, [9][10][11][12][13] making it necessary to develop blood-saving strategies. 7,9,14,15 The most important factor in the development of anemia in HF is blood loss; however, some other mechanisms (renal failure, inflammation, iatrogenic hemodilution) are also implicated, prompting the choice of different therapeutic approaches. [14][15][16][17][18][19][20][21] Although evidence that supporting marrow RBC production saves RBC transfusion is weak, an increasing number of studies have demonstrated notable reductions in RBC transfusion, nosocomial infections, hospital stay, and even survival.…”

“…7,9,14,15 The most important factor in the development of anemia in HF is blood loss; however, some other mechanisms (renal failure, inflammation, iatrogenic hemodilution) are also implicated, prompting the choice of different therapeutic approaches. [14][15][16][17][18][19][20][21] Although evidence that supporting marrow RBC production saves RBC transfusion is weak, an increasing number of studies have demonstrated notable reductions in RBC transfusion, nosocomial infections, hospital stay, and even survival. [20][21][22][23][24] Most of these previous studies were performed using intravenous (IV) iron sucrose administered in a period ranging from 2 to 6 days.…”

“…The increasing incidence of HF in this population has also raised the need for this valuable and scarce resource. Additionally, RBC transfusions are not without complications, making it necessary to develop blood‐saving strategies …”

How would I establish a perioperative blood salvage program?

“…An autotransfusion service (ATS), when combined with other blood management strategies, can result in significant reductions in the use of allogeneic blood 8 . Such a service may be hospital based or provided by a third‐party vendor.…”

“…7 An autotransfusion service (ATS), when combined with other blood management strategies, can result in significant reductions in the use of allogeneic blood. 8 Such a service may be hospital based or provided by a third-party vendor. Before an institution creates such a program or signs a contract for such a service, there are many issues that should be addressed.…”