Patient Blood Management (PBM)

For planned surgical procedures with an expected perioperative blood loss of more than 500 ml or a transfusion probability of more than 10 %, patients are called to the anesthesia consultation 10 to 14 days before the operation. As part of this preoperative clarification, both the hemoglobin (Hb value) and the iron status (ferritin and transferrin saturation) are determined.

The Institute of Anaesthesiology employs Dr. Gabriela Spahn, a proven expert as Patient Blood Manager, to provide our patients with the best possible care.

Minimization of perioperative blood loss

1. Careful surgical hemostasis
2. Cellsaver (intraoperative automated autotransfusion). In tumor surgery, we have the option of irradiating the patient’s own blood before retransfusion
3. Avoidance and immediate treatment of coagulopathy. To this end, blood coagulation is monitored closely using ROTEM® and specific laboratory values and corrected individually and in a targeted manner using a coagulation algorithm with antifibrinolytics, coagulation factors and blood products.
4. Maintaining normothermia

Improvement in anemia tolerance

1. Restrictive Hb transfusion thresholds are applied on a patient-adapted basis. An established transfusion algorithm is used for this purpose.
2. High FiO2 of 80 – 100% are used to improve oxygenation and O2 delivery to the tissues.
3. Situations with very high O2 consumption are avoided.

Targeted and restrictive use of blood products

1. Restrictive Hb transfusion thresholds are applied on a patient-adapted basis. The algorithm for the transfusion of blood and blood products in the event of massive bleeding serves this purpose.
2. Platelet and plasma transfusions are used exclusively according to the above coagulation algorithm.

Treatment principles 2-4 are used for operations that are not planned for the long term.

• Television documentary on patient blood management
• Click here to go to the PBM research page