title: Current status of pharmacologic therapies in patient blood management.
abstract: Patient blood management(1,2) incorporates patient-centered, evidence-based medical and surgical approaches to improve patient outcomes by relying on the patient's own (autologous) blood rather than allogeneic blood. Particular attention is paid to preemptive measures such as anemia management. The emphasis on the approaches being "patient-centered" is to distinguish them from previous approaches in transfusion medicine, which have been "product-centered" and focused on blood risks, costs, and inventory concerns rather than on patient outcomes. Patient blood management(3) structures its goals by avoiding blood transfusion(4) with effective use of alternatives to allogeneic blood transfusion.(5) These alternatives include autologous blood procurement, preoperative autologous blood donation, acute normovolemic hemodilution, and intra/postoperative red blood cell (RBC) salvage and reinfusion. Reviewed here are the available pharmacologic tools for anemia and blood management: erythropoiesis-stimulating agents (ESAs), iron therapy, hemostatic agents, and potentially, artificial oxygen carriers.
authors.affiliation: Pathology Department, Stanford University, 300 Pasteur Drive Room H-1402, M/C 5626 Stanford, CA 94305, USA. ltgoodno@stanford.edu
authors.forename: Lawrence Tim
authors.initials: LT
authors.lastname: Goodnough
authors.forename: Aryeh
authors.initials: A
authors.lastname: Shander
mesh_terms: D000740:Anemia / Q000188:drug therapy / Q000628:therapy; D016063:Blood Loss, Surgical; D001802:Blood Substitutes / Q000627:therapeutic use; D001803:Blood Transfusion / Q000379:methods*; D001804:Blood Transfusion, Autologous; D001810:Blood Volume / Q000502:physiology; D019090:Case Management; D004358:Drug Therapy; D004920:Erythropoiesis / Q000187:drug effects; D004921:Erythropoietin / Q000627:therapeutic use; D006397:Hematinics / Q000627:therapeutic use; D006438:Hemodilution; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D007501:Iron / Q000627:therapeutic use; D057725:Operative Blood Salvage; D018802:Patient-Centered Care
chemical_list: D001802:Blood Substitutes; D006397:Hematinics; D006490:Hemostatics; D004921:Erythropoietin; D007501:Iron