Patient Blood Management Does the Approach also make sense in Children?

Patient blood management describes an interdisciplinary concept which aims at rational and adequate use of blood products accompanied by strategies to prevent and treat anemia, to reduce blood loss and to use alternatives to blood transfusion. While patient blood management has been widely implemented in adult medicine, concepts for such measures in the care of children are rare. The basic principles of preoperative evaluation, optimization of blood volume, perioperative minimizing of blood loss and a differentiated use of blood products are effective both in adults and children. There are differences in the physiology of hemoglobin and cardiovascular systems, particularly in the first year of life. It can be difficult to determine impending anemic hypoxia in children, so that indication for transfusion based on standardized hemoglobin threshold values should always be supported by an individual risk-benefit analysis based on clinical assessment.