Résumé
The Patient Blood Management (PBM) aims in managing patients with anaemia and/or hemor-rhage blood loss in the perioperative period and preventing any unnecessary blood transfusion within a multidisciplinary strategy. PBM is based on 3 pillarscornerstones: optimisation of patient blood volumehaemoglobin and iron deficiency, decreasing of blood loss and optimising anaemia tolerance. Fifteen to 40 % of patients with preoperative anaemia and more than 50 % patients with no preoperative anaemia scheduled for surgery with potential blood loss risk have proven iron deficiency or low iron stores before surgery. Preoperative anaemia and/or iron deficiency are associated with and increased blood transfusion, postoperative complications, mortality rates and a longer hospital stayduration. A PBM strategy is associated with a reduction of postoperative complications in most of the published studies and could be associated with a reduced perioperative and hospital mortality rates. The implementation of a simplified PBM required to increase ASE use, intravenous iron infusion in order to reduce the rate of patients with anaemia before scheduled surgery, the use of cell saver, tranexamic acid use, decreasing the threshold for blood transfusion, decreasing perioperative blood loss, massive blood transfusion and the number of red blood cell transfusion per patient. PBM related hospital stay reduction and cost effectiveness have been recently challenged. It could be suggested to associate PBM recommendations to RAAC strategy.