3.4 Effect of non-transfusion interventions to increase haemoglobin concentration
Question 6 (Interventional question) (GNQ3)
In patients undergoing surgery, what is the effect of non-transfusion interventions to increase haemoglobin concentration on morbidity, mortality and need for RBC blood transfusion?
RBC, red blood cell
Iron is one of the main regulators of erythropoiesis: iron supply may be a limiting factor in erythropoiesis following surgery. It is essential that preoperative iron stores are adequate, so that patients can respond to the increase in erythropoiesis stimulated by blood loss.
Where preoperative anaemia is identified, it is important to determine its aetiology, so that appropriate therapy can be given. For example, in iron deficiency anaemia, iron therapy will correct anaemia, whereas, in anaemia of chronic disease (also known as anaemia of inflammation) and anaemia of renal impairment, the addition of erythropoiesis-stimulating agents (ESAs) may be required.