Role of intravenous iron therapy for management of perioperative anaemia: A narrative review

Abstract

Anaemia is a frequent problem in surgical patients, and the commonest cause is iron deficiency. There is no agreement among perioperative clinicians on the utility of intravenous (IV) iron therapy in surgical patients. In this study, publications in Medline, Web of Science, and Embase databases, along with major perioperative guidelines up until 2022 were searched using specific key words, and relevant papers that investigated IV iron therapy in the perioperative settings were screened out. Management of perioperative anaemia is comprehensively discussed in major guidelines. However, the diagnosis and management of iron deficiency is not as straightforward as those for anaemia. Iron metabolism is a complex process. IV iron supplementation remains the treatment choice for perioperative iron deficiency; however, it has limited and conflicting evidence of benefits in surgical patients. IV iron replacement, as a part of patient blood management, has shown benefit in perioperative anaemia.