Anestéziológia a intenzívna medicína 1/2023

Preoperative anaemia: prevalence, causes, consequences, and management

Preoperative anaemia is affecting at least a third of patients undergoing elective surgery and is a significant and modifiable risk factor for increased perioperative morbidity and mortality. Iron deficiency is the most common cause of preoperative anaemia and should be corrected. Intravenous iron is efficacious and safe and should be used in patients in whom oral iron is not tolerated or if the time before surgery is short. Erythropoiesis-stimulating agents (ESA) might be suggested (after correction of nutritional deficiencies) for anaemic patients with kidney disease or chronic inflammation and elderly patients with anaemia of unknown cause and adequate iron supply should always be ensured. Elective surgery should be postponed until preoperative anaemia has been appropriately treated. An easy-to-follow algorithm for the detection, evaluation, and appropriate treatment of anaemia and iron deficiency in surgical patients should be used.

Keywords: preoperative anaemia, iron deficiency, erythropoiesis stimulating agents, algorithm