Blood Transfusion: Preoperative Anemia

Anemia is defined as insufficient circulating red cell mass with a hemoglobin of ? 130 in men ? 120 in women. Iron deficient anemia is the most common type of anemia worldwide and in the surgical population. Preoperative anemia affects 30-40% of patients undergoing surgery and is an independent risk factor for perioperative red blood cell transfusion which may increase postoperative complications and increase hospital length of stay, morbidity and mortality.

This module will examine the etiology of preoperative anemia, discuss appropriate investigations to identify the causes of anemia in your patients, and outline appropriate treatment strategies.

After completing this module, you will be able to:

• Explain the importance of screening for preoperative anemia to minimize exposure to allogenic blood and improve patient access to surgical services
• Describe the appropriate investigations required to identify the cause of preoperative anemia
• Identify and discuss the etiology of preoperative anemia
• Interpret common laboratory results consistent with iron deficiency anemia
• Outline an appropriate treatment strategy for preoperative anemia depending on the cause and urgency of the surgical procedure
• Select the most appropriate method of iron replacement depending on time available and with the goal of minimizing allogenic blood exposure

This continuing professional development (CPD) program has been designed to consider the following roles as defined by the CanMEDS Physician Competency Framework:

• Medical Expert
• Communicator
• Collaborator