CLINICAL OVERVIEW

Preoperative Anemia Management

This clinical overview equips physicians and other health professionals with a practical approach to managing preoperative anemia in adult patients. It emphasizes the importance of anemia screening for all surgical patients given its high prevalence and association with increased perioperative morbidity and mortality. The overview details the diagnostic workup, including initial blood work such as complete blood count, reticulocyte count, iron studies, folate and B12 levels, inflammatory markers, and renal function tests. It presents a proposed algorithm for anemia detection, evaluation, and management, guiding clinicians through the process of identifying the underlying cause and initiating appropriate treatment. The article focuses on treatment strategies involving iron, vitamin B12, and folic acid supplementation, with detailed discussions on oral and intravenous iron administration. It also explores the use of erythropoiesis-stimulating agents (ESAs), including indications, contraindications, and potential complications. The overview addresses special considerations, such as managing anemia in patients with chronic kidney disease and the importance of recognizing and treating nonanemic iron deficiency. Finally, it touches on follow-up monitoring and potential complications of treatment, providing a comprehensive resource for healthcare professionals involved in the care of surgical patients.