The chiasm: transfusion practice versus patient blood management.

In recent years it became increasingly clear that allogeneic red blood cell (RBC) transfusions result in increased mortality and major adverse clinical outcomes. The major risk factors for RBC transfusions are preoperative anaemia, high perioperative blood loss and liberal transfusion triggers. Patient blood management (PBM), the bundle of preoperative anaemia treatment, measures to reduce perioperative blood loss and optimising anaemia tolerance, aims at minimising RBC transfusion needs and improving clinical outcomes. PBM has been adopted by the World Health Organization as the new standard of care and all member states are urged to implement this concept. Australia is leading the world in that PBM is indeed implemented at the current time.