title: [Patient blood management: Current state of the literature].
abstract: BACKGROUND
  Preoperative anemia has a prevalence of approximately 30% and is one of the strongest predictors of perioperative red blood cell (RBC) transfusion. It is rarely treated although it is an independent risk factor for the occurrence of postoperative complications. Additionally, the high variability in the worldwide usage of RBC transfusions is alarming. Due to these serious deficits in patient care, in 2011 the World Health Organization recommended the implementation of a patient blood management (PBM).
  
  
  OBJECTIVE
  This article provides information about PBM as a multidimensional and interdisciplinary approach.
  
  
  METHODS
  A selective literature search was carried out in the Medline and Cochrane library databases including consideration of national and international guidelines.
  
  
  RESULTS
  A PBM promotes the medically and ethically appropriate use of all available resources, techniques and materials in favor of an optimized perioperative patient care. Patients' own resources should be specifically protected, strengthened and used and include (i) diagnosis and therapy of preoperative anemia, (ii) minimizing perioperative blood loss, (iii) blood-conserving surgical techniques, (iv) restriction of diagnostic blood sampling, (v) utilization of individual anemia tolerance, (vi) optimal coagulation and hemotherapy concepts and (vii) guideline-based, rational indications for the use of RBC transfusions.
  
  
  CONCLUSIONS
  A PBM should be advocated as an incentive to evaluate and critically optimize local conditions. An individual, interdisciplinarily structured bundle of different PBM measures has great potential to optimize the quality of patient care and to make it safer.
authors.affiliation: Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland. patrick.meybohm@kgu.de.
authors.forename: P
authors.initials: P
authors.lastname: Meybohm
authors.affiliation: Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.
authors.forename: D
authors.initials: D
authors.lastname: Fischer
authors.affiliation: Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Schnitzbauer
authors.affiliation: Klinik für Thorax-, Herz- und Thorakale Gefäßchirurgie, Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Zierer
authors.affiliation: Klinik für Gefäß- und Endovascularchirurgie, Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Schmitz-Rixen
authors.affiliation: Klinik für Urologie und Kinderurologie, Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Deutschland.
authors.forename: G
authors.initials: G
authors.lastname: Bartsch
authors.affiliation: Institut für Transfusionsmedizin und Immunhämatologie, DRK-Blutspendedienst Baden-Württemberg - Hessen gemeinnützige GmbH, Frankfurt am Main, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Geisen
authors.affiliation: Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.
authors.forename: K
authors.initials: K
authors.lastname: Zacharowski
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000150:complications / Q000628:therapy*; D016063:Blood Loss, Surgical; D017707:Erythrocyte Transfusion; D005858:Germany; D006801:Humans; D033183:Interdisciplinary Communication; D000070516:Intersectoral Collaboration; D019990:Perioperative Care; D011183:Postoperative Complications / Q000097:blood / Q000628:therapy*; D011785:Quality Assurance, Health Care; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Hemotherapy; Packed red blood cells; Patient blood management; Perioperative outcome; Transfusion