Perioperative Anemia Management as Part of PBM in Cardiac Surgery - A Narrative Updated Review

J Cardiothorac Vasc Anesth. 2020 Apr;34(4):1060-1073. doi: 10.1053/j.jvca.2019.06.047. Epub 2019 Jul 4.


Anemia is common in patients with cardiac disease. Iron deficiency is the cause of anemia in about 80% of all cases. Preoperative anemia is associated with an increased morbidity and mortality in patients undergoing cardiac surgery. The risk of receiving red blood cell transfusions, which are potentially associated with severe side effects, is very high in these patients. Patient Blood Management (PBM) is a multidisciplinary approach to manage anemia, minimize unnecessary blood loss, and optimize transfusion therapy. PBM comprises 3 pillars: (1) detection and treatment of preoperative anemia, (2) reduction of perioperative blood loss, and (3) optimization of allogeneic blood therapy. The World Health Organization has urged all Member States to implement PBM. This narrative review focuses on pre-, intra-, and postoperative strategies to detect, prevent, and treat anemia as part of PBM in cardiac surgery.

Keywords: Patient Blood Management; anemia; cardiac surgery; ferritin; iron supplementation.

Publication types

  • Review

MeSH terms

  • Anemia* / diagnosis
  • Anemia* / therapy
  • Blood Transfusion
  • Cardiac Surgical Procedures* / adverse effects
  • Erythrocyte Transfusion
  • Hemorrhage
  • Humans