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Role of anesthesiologists in managing perioperative anemia

Steinbicker, Andrea U.

Current Opinion in Anesthesiology: February 2019 - Volume 32 - Issue 1 - p 64–71
doi: 10.1097/ACO.0000000000000671

Purpose of review Anemia can contribute negatively to a patient‘s morbidity and mortality. Which treatment options do exist and what role do anesthesiologists play in management of perioperative anemia treatment? This review gives an overview about recent findings.

Recent findings Patient Blood Management and standards for the management and treatment of anemia have been established worldwide. Various logistic settings and approaches are possible. With a special focus on cardiovascular anesthesia, intravenous iron is a therapeutic option in the preoperative setting. Autologous blood salvage is a standard procedure during surgery. Restrictive transfusion triggers in adult cardiac surgery have been shown to be beneficial in the majority of studies. Elderly patients and defined comorbidities might require higher transfusion triggers. Both, intravenous and oral iron increase hemoglobin values when given prior to surgery. Oral iron is effective when given several weeks prior to elective surgery. Erythropoietin is a treatment decision individualized to each patient.

Summary Within the previous 18 months, important publications have demonstrated the established role of anesthesiologists in managing perioperative anemia. A substantial pillar for anemia treatment is the implementation of Patient Blood Management worldwide.

Department of Anesthesia, Intensive Care and Pain Medicine, University Hospital Muenster, University of Muenster, Muenster, Germany

Correspondence to Andrea U. Steinbicker, MD, MPH, Westfaelische Wilhelms-Universiteat Muenster, Muenster; Muenster University Hospital, Albert-Schweitzer Campus 1, Building A1, 48149 Muenster, Germany. Tel: +0049 251 83 47898; e-mail:

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