Preoperative and postoperative correction of anaemia

Preoperative anaemia in adults and children appears to be a strong predictor for perioperative blood transfusion across various types of conditions and surgeries and may be associated with adverse events. B

We recommend that patients at risk of bleeding are assessed for anaemia 3 to 8 weeks before surgery. 1C

If anaemia is present,werecommend identifying the cause (iron deficiency, renal insufficiency or inflammation). 1C

We recommend treating iron deficiency with iron supplementation. 1B

We recommend the use of intravenous iron in preference to oral iron. 1C

If other causes of anaemia have been excluded or treated, we suggest erythropoietin-stimulating agents. 2B

If autologous blood donation is performed, we suggest treatment with iron and/or erythropoietin-stimulating agents to avoid preoperative anaemia and increased overall transfusion rates. 2C

In patients with preoperative anaemia, we recommend the use of combined therapy with intravenous iron and erythropoietin along with a restrictive transfusion policy. 1C

In non-cancer patients with preoperative anaemia scheduled for elective major surgery, we recommend postponing surgery until anaemia has been corrected. 1C

In patients who are anaemic following surgery, we suggest the use of intravenous iron. 2C