BACKGROUND: Preoperative @entity417 and perioperative blood transfusion are both identifiable and preventable surgical risks. @entity1 blood management is a multimodal approach to address this issue. It focuses on three pillars of care: the detection and treatment of preoperative @entity417 ; the reduction of perioperative @entity190 ; and harnessing and optimizing the @entity1 -specific physiological reserve of @entity417 , including restrictive haemoglobin transfusion triggers. This article reviews why @entity1 blood management is needed and strategies for its incorporation into surgical pathways. METHODS: Studies investigating the three pillars of @entity1 blood management were identified using PubMed, focusing on recent evidence-based guidance for perioperative management. RESULTS: @entity417 is common in surgical practice. Both @entity417 and blood transfusion are independently associated with adverse outcomes. Functional @entity58343 (iron restriction due to increased levels of hepcidin) is the most common cause of preoperative @entity417 , and should be treated with intravenous iron. Intraoperative @entity190 can be reduced with antifibrinolytic drugs such as tranexamic acid, and cell salvage should be used. A restrictive transfusion practice should be the standard of care after surgery. CONCLUSION: The significance of preoperative @entity417 appears underappreciated, and its detection should lead to routine investigation and treatment before elective surgery. The risks of unnecessary blood transfusion are increasingly being recognized. Strategic adoption of @entity1 blood management in surgical practice is recommended, and will reduce costs and improve outcomes in surgery.

XXXX blood management to reduce surgical risk.

@entity1 :: ('9606', 'Species') :: ['patient', 'Patient'] @entity190 :: ('MESH:D006473', 'Disease') :: ['blood loss'] @entity417 :: ('MESH:D000740', 'Disease') :: ['anaemia', 'Anaemia'] @entity58343 :: ('MESH:D018798', 'Disease') :: ['iron deficiency']
@entity1 :: (9606,Species) :: ['Patient']
