Perioperative intravenous iron, with or without erythropoietin, plus restrictive transfusion protocol reduce the need for allogeneic blood after knee replacement surgery

Abstract

This blood saving protocol seems to be effective for reducing ABT in TKR patients. Which patients are more likely to benefit from either perioperative iron administration or selective addition of postoperative blood salvage to pharmacologic treatment, however, needs to be further evaluated.

Preoperative anemia is associated with increased use of hospital resources in patients undergoing elective hepatectomy

“…44 The same authors demonstrated subsequently that the combination of preoperative parenteral iron, erythropoietin, and autologous blood transfusion from intraoperative blood losses also decrease the duration of hospitalization compared with a control group that did not receive any of these interventions. 45 Neither study demonstrated adverse events related to the administration of parenteral iron and/or erythropoietin in their orthopedic population without underlying malignancy. 44,45 On the basis of these studies as well as several others, a consensus statement on the correction of preoperative anemia was issued by a European group of anesthesiologists.…”

“…45 Neither study demonstrated adverse events related to the administration of parenteral iron and/or erythropoietin in their orthopedic population without underlying malignancy. 44,45 On the basis of these studies as well as several others, a consensus statement on the correction of preoperative anemia was issued by a European group of anesthesiologists. 40 Recommendations included routine measurement of iron studies, vitamin B12, and folate in patients older than 60 years of age undergoing elective operations with consideration of supplementation for anemic patients with abnormal results, once unexplained causes of anemia have been excluded.…”

Patient Blood Management in Europe

“…iron, and ESA reduced the use of ABT in patients (n¼139) undergoing TKR surgery. 76 In this study, patients who received unwashed shed blood after operation (if their preoperative Hb was ,13.0 g dl 21 ), in addition to ESA and i.v. iron, showed a significantly reduced hospital stay compared with those who received i.v.…”

Optimal Iron Replacement for Colorectal Cancer-Induced Anaemia

“…Several observational studies indicate significant rises in Hb and reductions in transfusion requirement in pre-operative patients after administration of intravenous iron sucrose in patients undergoing arthroplasty [14,15] and hysterectomy [16]. A Spanish study including 84 patients reported a significant rise in haemoglobin of 1.6g/dl over 3-5 weeks preoperatively in anaemic unselected surgical patients receiving intravenous iron sucrose [17].…”