Patient Blood Management Guidelines: Module 2

Perioperative

5 Future directions

5.1.3 Effect of minimisation of blood loss on outcomes

Question 3 (interventional)

In patients undergoing surgery, what is the effect of perioperative strategies that minimise blood loss on morbidity, mortality and blood transfusion?

Further studies are required on safety, efficacy and methodologies for ANH and perioperative cell salvage.

In the trials examined for this module, the role and methods of ANH and intraoperative cell salvage were biased, because the studies were not blinded and lacked sufficient power. The evidence for the use of washed rather than unwashed blood is unclear; further studies are needed to evaluate the safety of postoperative cell salvage using unwashed blood.

There is a need for further research in point-of-care testing including thromboelastographic techniques such as TEG and ROTEM (rotational thromboelastometry).