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Anaesthesia. 2018 Nov;73(11):1418-1431. doi: 10.1111/anae.14358. Epub 2018 Jul 31.

An international consensus statement on the management of postoperative anaemia after major surgical procedures.

Author information

1
Department of Surgical Specialties, Biochemistry and Immunology, School of Medicine, University of Málaga, Málaga, Spain.
2
Department of Colorectal Surgery, Nottingham Digestive Diseases Centre, National Institute for Health Research Biomedical Research Unit, Nottingham University Hospitals, Nottingham, UK.
3
Department of Anaesthesia, University Hospital Mar-Esperanza, Barcelona, Spain.
4
Division of Surgery, University College London, London, UK.
5
Department of Internal Medicine, University Hospital Virgen de la Victoria, Málaga, Spain.
6
Department of Haematology and Medicine, Launceston General Hospital, Launceston, Australia.
7
Menzies Institute for Medical Research, University of Tasmania, Australia.
8
Section of Surgical Pathophysiology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark.
9
Department of Anaesthesia and Intensive Care, Evangelical Hospital, Vienna, Austria.
10
Italian National Blood Centre, National Institute of Health, Rome, Italy.
11
Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt, Germany.
12
Department of Anaesthesia, Royal Marsden NHS Foundation Trust, London, UK.
13
Anaesthesiology, Critical Care and Hyperbaric Medicine, Englewood Hospital and Medical Centre, Englewood, NJ, USA.
14
TeamHealth Research Institute, Englewood, NJ, USA.
15
Department of Transfusion Medicine, Sanquin Blood Bank, Amsterdam, The Netherlands.
16
Department of Internal Medicine, Groene Hart Hospital, Gouda, The Netherlands.
17
Institute of Anaesthesiology, University Hospital of Zurich, Zurich, Switzerland.
18
Intensive Care Medicine and Operating Room Management, University Hospital of Zurich, Zurich, Switzerland.
19
Department of Anaesthesia and Intensive Care, Royal Papworth Hospital, Cambridge, UK.

Abstract

Despite numerous guidelines on the management of anaemia in surgical patients, there is no pragmatic guidance for the diagnosis and management of anaemia and iron deficiency in the postoperative period. A number of experienced researchers and clinicians took part in a two-day expert workshop and developed the following consensus statement. After presentation of our own research data and local policies and procedures, appropriate relevant literature was reviewed and discussed. We developed a series of best-practice and evidence-based statements to advise on patient care with respect to anaemia and iron deficiency in the postoperative period. These statements include: a diagnostic approach to iron deficiency and anaemia in surgical patients; identification of patients appropriate for treatment; and advice on practical management and follow-up that is easy to implement. Available data allow the fulfilment of the requirements of Pillar 1 of Patient Blood Management. We urge national and international research funding bodies to take note of these recommendations, particularly in terms of funding large-scale prospective, randomised clinical trials that can most effectively address the important clinical questions and this clearly unmet medical need.

KEYWORDS:

anaemia; erythropoiesis stimulating agents; iron deficiency; iron supplementation; postoperative period; transfusion

PMID:
30062700
DOI:
10.1111/anae.14358

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