Institutionally Adopted Perioperative Blood Management Program Significantly Decreased the Transfusion Rate of Patients Having Primary Total Hip Replacement Surgery

Table 1

Elements of the general PBM program as integrated into our institutional protocol.

Anemia screening/correction	Preoperative screening	Yes	Surgery, if Hgb > 120 g/l
	Anemia correction, iron supplements	Yes
	Anemia correction, EPO treatment	No	Off label in Hungary
Minimizing blood loss	Less invasive surgical technique	No	Not changed during study period
	Tranexamic acid administration	Yes	Liberal use
	Autologous blood donation	No	Not supported by national blood service
	Hemostasis optimization, preoperative	Yes	Preoperative LMWH only if high risk
	Hemostasis optimization, intra/postoperative	Yes	Viscoelastometry-guided protocol
	Cell salvage techniques	No	Not beneficial
	Normothermia	Yes
Increasing anemia tolerance	Advanced postoperative care	Yes	Postop HDU introduced
Rational hemotherapy	Restrictive transfusion threshold	Yes	Transfusion, if Hgb < 80 g/l