Bloodconservation

Blood conservation refers to a set of medical strategies designed to reduce blood loss and preserve a patient's own blood to minimize exposure to donor blood transfusions. It is commonly implemented as part of patient blood management (PBM), a multidisciplinary program that integrates preoperative, intraoperative, and postoperative measures to optimize hemostasis and oxygen delivery.

Core elements include preoperative optimization of red cell mass (identifying and treating preexisting anemia with iron, vitamin B12, and folate; consideration of erythropoiesis-stimulating agents in selected patients), intraoperative techniques to minimize loss (minimally invasive surgery, meticulous hemostasis, controlled hypotension when appropriate), and strategies to recover autologous blood (cell salvage) and limit transfusion requirements.

Intraoperative pharmacologic methods, notably antifibrinolytics such as tranexamic acid or ε-aminocaproic acid, are commonly used to reduce bleeding. Normovolemic hemodilution—removing some patient blood early and reinfusing it later—may be employed in suitable cases. Restrictive transfusion thresholds guide when donor blood is given.

Postoperative measures focus on continued minimization of bleeding and optimizing recovery, including careful drainage management and early mobilization, as well as ongoing anemia management if needed. PBM programs emphasize multidisciplinary cooperation among surgeons, anesthesiologists, nurses, and transfusion services to tailor interventions to the patient.

Outcomes associated with blood conservation programs include reduced exposure to allogeneic transfusions, lower infection and transfusion-related complications, shorter hospital stays, and potential cost savings. Adoption of PBM practices is encouraged by major health organizations and professional societies, though applicability depends on patient context and resource availability.