Optimizing Preoperative Anemia to Improve Patient Outcomes

Brittany N Burton; Alison M A'Court; Ethan Y Brovman; Michael J Scott; Richard D Urman; Rodney A Gabriel

doi:10.1016/j.anclin.2018.07.017

Optimizing Preoperative Anemia to Improve Patient Outcomes

Anesthesiol Clin. 2018 Dec;36(4):701-713. doi: 10.1016/j.anclin.2018.07.017. Epub 2018 Oct 12.

Authors

Brittany N Burton¹, Alison M A'Court², Ethan Y Brovman³, Michael J Scott⁴, Richard D Urman⁵, Rodney A Gabriel⁶

Affiliations

¹ School of Medicine, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093, USA.
² Department of Anesthesiology, Preoperative Care Clinic, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093, USA.
³ Department of Anesthesiology, Perioperative and Pain Medicine, Cardiothoracic Anesthesia, Harvard Medical School, Brigham & Women's Hospital, 75 Francis St, Boston, MA 02115, USA.
⁴ Department of Anesthesiology, Virginia Commonwealth University Health System, 1200 East Broad Street, PO Box 980695, Richmond, VA 23298, USA; Department of Anesthesiology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104, USA.
⁵ Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, 75 Francis St, Boston, MA 02115, USA.
⁶ Division of Regional Anesthesia and Acute Pain, Department of Anesthesiology, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093, USA; Department of Medicine, Division of Biomedical Informatics, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093, USA. Electronic address: ragabriel@ucsd.edu.

PMID: 30390789
DOI: 10.1016/j.anclin.2018.07.017

Abstract

Anemia is a decrease in red blood cell mass, which hinders oxygen delivery to tissues. Preoperative anemia has been shown to be associated with mortality and morbidity following major surgery. The preoperative care clinic is an ideal place to start screening for anemia and discussing potential interventions in order to optimize patients for surgery. This article (1) reviews the relevant literature and highlights consequences of preoperative anemia in the surgical setting, and (2) suggests strategies for screening and optimizing anemia in the preoperative setting.

Keywords: Anemia; Hemoglobin; Outcomes; Transfusion.

Publication types

Review

MeSH terms

Anemia / diagnosis*
Anemia / therapy*
Blood Transfusion
Humans
Iron / therapeutic use
Length of Stay
Postoperative Complications / prevention & control*
Preoperative Care / methods*

Substances

Iron