Assessment and treatment of preoperative anemia: Continuing Professional Development

Abstract

PURPOSE:The purpose of this continuing professional development (CPD) module is to review the risk of anemia and transfusion in perioperative patients and to propose an approach for the diagnosis and treatment of preoperative anemia.PRINCIPAL FINDINGS:Preoperative anemia has been associated with increased transfusion of red blood cells, organ injury, and mortality. Postoperative anemia has also been associated with impaired recovery from surgery. Transfusion also increases the risk of infection, organ injury, and mortality. Preoperatively, iron deficiency anemia can be corrected with oral or intravenous iron; certain types of patients might respond to administration of erythrocyte stimulating agents (ESAs). With ESAs, the increased risk of thrombosis should be balanced against the expected benefit.CONCLUSIONS:Preoperative diagnosis and treatment of anemia may reduce the risk of morbidity and mortality associated with both anemia and transfusion.