| Problems |
Solutions |
| Inadequate diagnosis and treatment of preoperative anemia |
Preoperative diagnosis and treatment of anemia, stabilization of comorbidities, physical optimization, deferring the operation if necessary, determining the patient's bleeding risk, and scheduling surgery accordingly[23] |
| Inappropriate, irrational, traditional blood and blood product transfusion |
Management of anesthesia according to patient blood management, usage of tranexamic acid, retrograde autologous priming and autologous donation in the pump, providing qualified surgery and meticulous hemostasis, prevention of hypothermia after cardiopulmonary bypass, and optimization of cardiopulmonary functions[24] |
| Insufficient information in indications for the use of cryoprecipitate, fibrinogen concentrate, antifibrinolytic, and prothrombin complex concentrate |
Ensuring the accuracy of the records of transfused patients by eradicating inappropriate blood stores |
| Inappropriate storage of blood in the clinics |
Establishment of a local blood center unit in the common aisle of operating theaters and elimination of problems related to transport distances and staff securing the cold chain of blood products |
| Lack of well-defined protocols for various critical clinical situations (i.e., massive transfusion protocol, critical cardiac/pulmonary/renal disease protocols, critical transfusion thresholds, and reversal protocols in antiplatelet/ anticoagulant use) |
Multidisciplinary preparation of required protocols in accordance with the patient profile and defining the transfusion practices clearly and precisely in the hospital protocol |
