Perioperative Anämie

Abstract

Anemia is a frequent finding, particularly in the elderly population, and usually indicative of a serious disease. The main causes of preoperative anemia are acute or chronic hemorrhage, iron deficiency, renal insufficiency, inflammatory and neoplastic diseases. A preexisting mild anemia may be enhanced or unmasked by surgically induced bleeding or repeated diagnostic phlebotomies, and by a postoperative erythropoietic dysfunction caused by the surgical trauma, irrespective of any hemorrhage. Low hemoglobin values are associated with a distinct increase of mortality and morbidity, both in the normal population and perioperatively and in the critically ill patients. The anemia-associated risk is exacerbated by preexisting cardiovascular disease, important intraoperative blood loss and advanced age. In contradiction to established therapeutical concepts, the administration of allogeneic blood beyond hemoglobin levels of 8-10 g/dl has not been found to decrease perioperative or intensive care morbidity or mortality. Rather, in addition to the inherent long-term risks of transfusions, a liberal transfusion strategy seems to increase the incidence of postoperative complications. Thus, current transfusion guidelines tend to be interpreted in an increasingly restrictive manner. Depending on the urgency of the clinical situation, the primary goal should be to diagnose and treat the underlying disease, rather than to focus on the symptom anemia. Time permitting, the patient's cardiovascular and pulmonary status should be optimized preoperatively. Furthermore, iron should be substituted to treat and prevent deficiency. Recombinant human erythropoietin has successfully been used to treat anemia of chronic renal failure and chronic disease, as well as in the perioperative and intensive care setting, and to support the efficiency of autologous programs.

Rocuronium Use in Anaesthetics Protocol in Canine Patients with Orthopedic Disease

“…In veterinary medicine there are no study, from our knowledge, to assess the degree of post operative anemia, but in human medicine, two major studies conclude that in 90% of orthopedic surgery anemia is present postoperative (Kulier, 2001;Dunne, 2002). After the surgery in our cases we noticed a mild anemia.…”

Strategies for the Management of Postoperative Anemia in Elective Orthopedic Surgery

“…The inflammatory 647977A OPXXX10.1177/1060028016647977Annals of PharmacotherapySteuber et al response has the potential to modify iron metabolism and decrease the body's ability to utilize iron stores. [7][8][9] Each pathway to the development of postoperative anemia must be considered when evaluating potential treatment strategies. Additionally, certain risk factors or patient demographics have been identified as predictors for postoperative anemia in the overall surgery population.…”

Impact of Preoperative Anemia on Outcome in Patients Undergoing Coronary Artery Bypass Graft Surgery

“…[1][2][3][4] A significant association of anemia with increased perioperative morbidity and mortality has been established in a multitude of settings and in both cardiac and noncardiac surgery. [1][2][3][4][5][6][7][8][9][10][11][12][13] Because of their extremely limited coronary reserve, patients undergoing coronary artery bypass grafting (CABG) surgery represent a population potentially most sensitive to the impact of low hemoglobin levels. 2,3,9,11 However, available data do not describe in detail the exact relationship between the individual degree of preoperative anemia and specific adverse outcomes of CABG patients and…”