title: "Patient blood management" in orthopaedic surgery.
abstract: Orthopaedic and trauma surgical procedures (OTS) can lead to significant blood losses and acute postoperative anaemia, which in many cases requires allogeneic blood transfusions (ABT). The clinical, economic and logistical disadvantages of ABT have promoted the development of multidisciplinary and multimodal programs generically known as Patient Blood Management (PBM) programs, which have as their objective to reduce or eliminate the need for ABT and improve clinical outcomes. These programs are supported by the implementation of four groups of perioperative measures: (1) use of restrictive transfusion criteria; (2) stimulation of erythropoiesis; (3) reduction of bleeding; and (4) autologous blood transfusion. In this article, a review is presented of the effectiveness, safety and recommendations of applicable strategies in OTS, as well as the barriers and requirements to the development and implementation of PBM programs in this surgical specialty.
authors: Servicio de Cirugía Ortopédica y Traumatología, Hospital Cruz Roja, Madrid, España. Electronic address: fercanillas@yahoo.es.
authors: Fernando
authors: F
authors: Canillas
authors: GIEMSA, Medicina Transfusional Perioperatoria, Facultad de Medicina, Universidad de Málaga, Málaga, España.
authors: Susana
authors: S
authors: Gómez-Ramírez
authors: Servicio de Hematología y Hemoterapia, Hospital General San Jorge, Huesca, España.
authors: José Antonio
authors: JA
authors: García-Erce
authors: GIEMSA, Medicina Transfusional Perioperatoria, Facultad de Medicina, Universidad de Málaga, Málaga, España.
authors: José
authors: J
authors: Pavía-Molina
authors: Servicio de Anestesiología y Reanimación, Hospital Clínico Virgen de la Victoria, Málaga, España.
authors: Aurelio
authors: A
authors: Gómez-Luque
authors: GIEMSA, Medicina Transfusional Perioperatoria, Facultad de Medicina, Universidad de Málaga, Málaga, España.
authors: Manuel
authors: M
authors: Muñoz
mesh_terms: D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001804:Blood Transfusion, Autologous; D057668:Bloodless Medical and Surgical Procedures / Q000379:methods*; D006397:Hematinics / Q000627:therapeutic use*; D006801:Humans; D019637:Orthopedic Procedures; D019990:Perioperative Care / Q000379:methods*; D017410:Practice Guidelines as Topic
chemical_list: D006397:Hematinics
keywords: Agentes antifibrinolíticos; Agentes estimuladores de la eritropoyesis; Allogeneic blood transfusion; Anaemia; Anemia; Antifibrinolytic agents; Autologous blood transfusion; Cirugía ortopédica; Erythropoiesis stimulating agents; Gestión integral del paciente; Hierro; Iron; Orthopedic surgery; Patient Blood Management; Pérdida quirúrgica de sangre; Surgical Blood Loss; Transfusión de sangre alogénica; Transfusión de sangre autóloga