Many Patient Blood Management programs are missing something very important (hint: If you ignore this, your patient may already be in trouble at the time of admission!). Dr. Aryeh Shander is here to explain why all PBM programs need to address preoperative anemia.
BBGuy and SABM
This episode is the second in my “friendly collaboration” with the Society for the Advancement of Blood Management (SABM.org). I am very grateful to Dr. Carolyn Burns from SABM for helping to arrange this interview. SABM is helping chart the course toward more effective PBM strategies, and I highly recommend you check out their resources and web site.
The real question is not whether a transfusion was appropriate.
The real question is whether a transfusion was AVOIDABLE.
Aryeh Shander, M.D., FCCM, FCCP, is the Emeritus Chair, Department of Anesthesiology, Critical Care Medicine, Pain Management and Hyperbaric Medicine at Englewood Hospital & Medical Center in Englewood, NJ. He is an Adjunct Clinical Professor of Anesthesiology, Medicine & Surgery at Icahn School of Medicine at Mount Sinai in New York City and Clinical Professor of Anesthesiology at Rutgers Medical School. Dr. Shander is the Executive Medical Director of The Institute for Patient Blood Management and Bloodless Medicine and Surgery at Englewood Hospital.
Dr. Shander lectures nationally and internationally on a variety of topics. His publications have appeared in numerous prestigious peer-reviewed medical journals. He is the author/editor of multiple book chapters and a contributor to numerous textbooks on blood management.
He is Past President of the Society for the Advancement of Blood Management (SABM) and is a Fellow of the American College of Critical Care Medicine and the American College of Chest Physicians. Dr. Shander is a founding member of the Board of Directors and was a Past President for National Anemia Action Council (NAAC). In 1997 Dr. Shander was recognized by Time magazine as one of America’s “Heroes of Medicine.” In 2018, Dr. Shander was the recipient of the International PBM Implementation Award from the Patient Blood Management European Network.
Dr. Shander received his medical degree from the University Of Vermont College Of Medicine and completed an internship and residency in Internal Medicine at Montefiore Medical Center in Bronx, New York, where he also served as Chief Resident. Additional postgraduate training included a fellowship in Critical Care Medicine and a residency in Anesthesiology, both at Montefiore Medical Center. Dr. Shander is board-certified in Internal Medicine, Critical Care, Anesthesiology and Hyperbaric Medicine.
DISCLAIMER: The opinions expressed on this episode are those of my guest and I alone, and do not reflect those of the organizations with which either of us is affiliated. Neither Dr. Shander nor I have any relevant financial disclosures.
- Article by Dr. Shander on preoperative anemia: Shander A. Preoperative anemia and its management. Transf Apher Sci 2014;50:13–15.
- True cost of transfusion: Shander A et al. Activity-based costs of blood transfusions in surgical patients at four hospitals. Transfusion 2010;50:753-765.
- Article by Dr. Shander et al on ESAs: Shander A et al. Erythropoiesis‐stimulating agents: friends or foes? Transfusion 2013;53:1867-1872
- Article outlining barriers to pre-op anemia optimization: Munoz M et al. ‘Fit to fly’: Overcoming barriers to preoperative haemoglobin optimization in surgical patients. Brit J Anaesth 2015;115(1):15–24.
- International consensus statement on pre-operative anemia management: Munoz M et al. International consensus statement on the peri-operative management of anaemia and iron deficiency. Anaesthesia 2017;72:233–247.
- NATA guidelines for preoperative anemia in orthopedic patients (includes awesome flow chart!): Goodnough LT et al. Detection, evaluation, and management of preoperative anaemia in the elective orthopaedic surgical patient: NATA guidelines. Brit J Anaesth 2011;106(1):13–22.
- SABM Paper on Pre-op Anemia: Anemia in the Pre-surgical Patient: Recognition, Diagnosis, and Management. SABM 2014
- Paper showing preop anemia is an independent risk factor for perioperative and postoperative complications: Seicean S et al. Preoperative Anemia and Perioperative Outcomes in Patients who Undergo Elective Spine Surgery. Spine 2013;38(15):1331–1341.