Improving Patient Outcomes by Reducing Anemia and Bleeding in Pediatric Spine Surgery

Children requiring spine surgery are often iron deficient and anemic. Pediatric spine surgery is associated with notable risk of perioperative acute blood loss. To manage acute blood loss, many pediatric patients undergoing spine surgery require allogeneic transfusion of blood products. Both anemia and blood transfusions are associated with morbidity, such as increased length of stay, perioperative costs, and rarely mortality. To mitigate these factors, applying ever evolving concepts related to patient blood management (PBM), blood conservation techniques (BCT), and enhanced recovery after surgery (ERAS) are effective means to reduce anemia and transfusions perioperatively during spine surgery. This review focuses on development of multidisciplinary teams to harness the potential of PBM, BCT, and ERAS strategies. PBM, BCT, and ERAS concepts applied perioperatively for pediatric patients undergoing spine surgery provide a means of mitigating anemia and reducing the requirement for blood transfusions.