British Committee for Standards in Haematology Guidelines on the Identification and Management of Pre‐Operative Anaemia

Kotzé, Alwyn; Harris, Andrea; Baker, Charles; Iqbal, Tariq; Lavies, N. G.; Richards, Toby; Ryan, Kate; Taylor, Craig; Thomas, Dafydd

doi:10.1111/bjh.13623

Cited by 139 publications

(131 citation statements)

References 66 publications

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“…Iron supplementation modalities according to the time of initiation. In major orthopaedic surgery, preoperative iron administration (4–6 weeks prior to surgery) is the standard approach for treating iron‐deficient patient iron recommended by most guidelines. Short‐term perioperative intravenous iron administration (up to 1 week before and/or after surgery) has been also suggested by some guidelines.…”

Section: Methodsmentioning

confidence: 99%

Short‐term perioperative iron in major orthopedic surgery: state of the art

Gómez‐Ramírez

Maldonado-Ruiz²,

Campos-Garrigues

et al. 2018

Vox Sanguinis

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In major orthopaedic surgery, it is recommended to detect and correct preoperative anaemia several weeks prior to surgery. However, in many cases, the procedure is urgent or the patient is evaluated shortly before the intervention. As iron deficiency is the leading cause of perioperative anaemia, an exhaustive review of the literature was performed to assess the efficacy and safety of short‐term perioperative intravenous, with or without erythropoietin, or postoperative oral or intravenous supplementation in major orthopaedic surgery. Overall, 20 studies met the inclusion criteria. There were 13 randomized trials (moderate quality) and seven observational studies (low to very low quality). The primary outcomes were reduction in transfusion requirements, haemoglobin increase and medication side‐effects during the study period. Data analysis showed that postoperative oral iron administration neither increased haemoglobin nor reduced transfusion requirements, and it was associated with significant gastrointestinal adverse effects (15%). In contrast, for some patient populations, perioperative or postoperative administration of intravenous iron, with or without recombinant erythropoietin, may reduce transfusion requirements and/or hasten the recovery from postoperative, with few clinically relevant adverse effects (<2%). However, discrepancies between randomized trials and observational studies on the possible beneficial effects of short‐term perioperative intravenous iron administration were found for patients undergoing surgery for hip fracture repair. Further studies are needed to elucidate when the treatment should be started, which combination of drugs should be used, and which patient groups would be most benefit.

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Section: Methodsmentioning

confidence: 99%

Short‐term perioperative iron in major orthopedic surgery: state of the art

Gómez‐Ramírez

Maldonado-Ruiz²,

Campos-Garrigues

et al. 2018

Vox Sanguinis

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“…In cardiac surgery, conflicting results have been found depending on whether intravenous iron was given with or without concomitant rHuEPO [31, 32]. Most guidelines from professional associations and international consensus documents recommend the administration of intravenous iron for the management of perioperative anemia [5, 14, 33-35]. …”

Section: Treatment Options For Iron Deficiencymentioning

confidence: 99%

“…In surgical patients, RBCT is associated with increased risk of infection, circulatory overload, thromboembolic events, prolonged hospitalization, impaired quality of life, cancer recurrence, and mortality, and should be minimized or avoided [52-57]. A restrictive RBCT policy and transfusing 1 RBC unit at a time, with post-RBCT reassessment, are strongly recommended by most guidelines [5, 14, 18, 32-35, 58]. …”

Section: Treatment Options For Iron Deficiencymentioning

confidence: 99%

Management of Perioperative Iron Deficiency Anemia

et al. 2019

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Preoperative anemia affects 30–40% of patients undergoing major surgery and is an independent risk factor for perioperative blood transfusion, morbidity, and mortality. Absolute or functional iron deficiency is its leading cause. Nonanemic hematinic deficiencies are also prevalent and may hamper preoperative hemoglobin optimization and/or recovery from postoperative anemia. As modifiable risk factors, anemia and hematinic deficiencies should be detected and corrected prior to major surgical procedures. Postoperative anemia is even more common (up to 80–90%) due to surgery-associated blood loss, inflammation-induced blunted erythropoiesis, and/or preexisting anemia. Preoperative oral iron may have a role in mild-to-moderate anemia, provided there is sufficient time (6–8 weeks) and adequate tolerance of oral preparations. Postoperative oral iron is of little value and rife with gastrointestinal adverse events. Intravenous iron should preferentially be used in cases of moderate-to-severe iron deficiency anemia, concomitant use of erythropoiesis-stimulating agents, short time to surgery or nonelective procedures, and for postoperative anemia management. Minor infusion reactions to intravenous iron are rare, the incidence of severe anaphylactic reactions is extremely low, and there is no increase in infections with intravenous iron. Currently available intravenous iron formulations allowing administration of large single doses are preferred.

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“…Dolayısıyla, mümkün olduğunca sağlık profesyonellerinin odaklanması gereken nokta cerrahi sırası dönemdeki kan kaybını önle-meye yönelik olmalıdır. 26 …”

Section: Anemiunclassified

A New Approach to Evidence Based Practices in Gynecological Surgery: ERAS Protocol and Nursing

Aksoy¹,

Yılmaz²

2018

Turkiye Klinikleri J Nurs Sci

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British Committee for Standards in Haematology Guidelines on the Identification and Management of Pre‐Operative Anaemia

Cited by 139 publications

References 66 publications

Short‐term perioperative iron in major orthopedic surgery: state of the art

Short‐term perioperative iron in major orthopedic surgery: state of the art

Management of Perioperative Iron Deficiency Anemia

A New Approach to Evidence Based Practices in Gynecological Surgery: ERAS Protocol and Nursing

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