'Fit to fly': Overcoming barriers to preoperative haemoglobin optimization in surgical patients

British Journal of Anaesthesia

Volumn 115, Issue 1, 2015, Pages 15-24

  Munoz M ^a   Gomez Ramirez S ^b   Kozek Langeneker, S ^c   Shander, A ^d   Richards, T ^e   Pavia J ^a   Kehlet, H ^f   Acheson, A G ^g   Evans, C ^h   Raobaikady, R ⁱ   Javidroozi, M ^d   Auerbach, M ^j  

^a UNIVERSITY OF MÁLAGA   (Spain)

^b Xanit International Hospital   (Spain)

^c Evangelical Hospital   (Austria)

^d ENGLEWOOD HOSPITAL AND MEDICAL CENTER   (United States)

^e UNIVERSITY COLLEGE LONDON   (United Kingdom)

^f UNIVERSITY OF COPENHAGEN   (Denmark)

^g Biomedical Research Unit   (United Kingdom)

^h CARDIFF AND VALE UNIVERSITY HEALTH BOARD   (United Kingdom)

ⁱ INSTITUTE OF CANCER RESEARCH   (United Kingdom)

^j GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE   (United States)

more..

Author keywords

blood; erythrocytes; preoperative period; surgery; transfusion

Indexed keywords

ERYTHROPOIETIN; HEMOGLOBIN; IRON;

ANEMIA; BLOOD TRANSFUSION; COST EFFECTIVENESS ANALYSIS; DISEASE SEVERITY; DRUG EFFICACY; DRUG MEGADOSE; HEMOGLOBIN DETERMINATION; HOSPITAL PERSONNEL; HUMAN; IRON DEFICIENCY; IRON THERAPY; MAJOR SURGERY; POPULATION; PREOPERATIVE PERIOD; PREVALENCE; PRIORITY JOURNAL; REVIEW; RISK FACTOR; SURGICAL PATIENT; THERAPEUTIC MISCONCEPTION; THROMBOSIS; WORKLOAD; WORLD HEALTH ORGANIZATION; FEMALE; MALE; OPERATIVE BLOOD LOSS; PREOPERATIVE CARE; STATISTICS AND NUMERICAL DATA; SURGERY;

ANEMIA; BLOOD LOSS, SURGICAL; BLOOD TRANSFUSION; FEMALE; HEMOGLOBINS; HUMANS; MALE; PREOPERATIVE CARE; RISK FACTORS; SURGICAL PROCEDURES, OPERATIVE;

EID: 84936770566     PISSN: 00070912     EISSN: 14716771     Source Type: Journal    
DOI: 10.1093/bja/aev165     Document Type: Review

References (78)

1. Walsh TS, Saleh EED. Anaemia during critical illness. Br J Anaesth 2006; 97: 278-91
2. Almac E, Bezemer R, Hilarius-Stokman PM, et al. Red blood cell storage increases hypoxia-induced nitric oxide bioavailability and methemoglobin formation in vitro and in vivo. Transfusion 2014; 54: 378-85
3. Park DW, Chun BC, Kwon SS, et al. Red blood cell transfusions are associated with lower mortality in patients with severe sepsis and septic shock: a propensity-matched analysis. Crit Care Med 2012; 40: 3140-5
4. Carson JL, Brooks MM, Abbott JD, et al. Liberal versus restrictive transfusion thresholds for patients with symptomatic coronary artery disease. Am Heart J 2013; 165: 964-71. e1
5. Shander A, Van Aken H, Colomina MJ, et al. Patient blood management in Europe. Br J Anaesth 2012; 109: 55-68
6. The Society for the Advancement of Blood Management 2012 definition of PBM. Available from http://SABM. org (accessed August 2014)
7. TheWorld Health Assembly Resolution on availability, safety and quality of blood products (WHA 63. 12). Adopted May 2010. Available from: http://www. who. int/medicines/areas/ quality-safety/regulation-legislation/icdra/WA-1B-quality- safety-BloodProducts. pdf (accessed August 2014)
8. Kozek-Langenecker S, Bettelheim P, Giurea A, et al. Interdisciplinary Recommendations for the Management of Anaemia (Patient Blood Management). Available from: http://www. oegari. at/web-files/dateiarchiv/473/PBM%20consensus%20of %20Austrian%20Societies%20&%20Organisations%202013% 20Version%201. 1. pdf (accessed August 2014)
9. Lunn JN, Elwood OC. Anaemia and surgery. Br Med J 1970; 3: 71-3
10. Beattie WS, Karkouti K, Wijeysundera DN, Tait G. Risk associated with preoperative anemia in noncardiac surgery: a single-center cohort study. Anesthesiology 2009; 110: 574-81
11. Jans ?, Jørgensen C, Kehlet H, Johansson PI; Lundbeck Foundation Centre for Fast-track Hip and Knee Replacement Collaborative Group. Role of preoperative anemia for risk of transfusion and postoperative morbidity in fast-track hip and knee arthroplasty. Transfusion 2014; 54: 717-26
12. Musallam KM, Tamim HM, Richards T, et al. Preoperative anaemia and postoperative outcomes in noncardiac surgery: a retrospective cohort study. Lancet 2011; 378: 1396-407
13. Leichtle SW, Mouawad NJ, Lampman R, Singal B, Cleary RK. Does preoperative anemia adversely affect colon and rectal surgery outcomes? J Am Coll Surg 2011; 212: 187-94
14. Ranucci M, Di Dedda U, Castelvecchio S, Menicanti L, Frigiola A, Pelissero G; Surgical and Clinical Outcome Research (SCORE) Group. Impact of preoperative anemia on outcome in adult cardiac surgery: a propensity-matched analysis. Ann Thorac Surg 2012; 94: 1134-41
15. Shander A, Goodnough LT, Javidroozi M, et al. IronDeficiency Anemia-Bridging the Knowledge and Practice Gap. Transfus Med Rev 2014; 28: 156-66
16. Shander A, Javidroozi M, Ozawa S, Hare GM. What is really dangerous: anaemia or transfusion? Br J Anaesth 2011; 107 (Suppl 1): i41-59
17. Wu WC, Schifftner TL, Henderson WG, et al. Preoperative hematocrit levels and postoperative outcomes in older patients undergoing noncardiac surgery. JAMA 2007; 297: 2481-8
18. Spahn DR. Anemia and patient blood management in hip and knee surgery. A systematic review of the literature. Anesthesiology 2010; 113: 482-95
19. World Health Organization. Haemoglobin Concentrations for the Diagnosis of Anaemia and Assessment of Severity. Geneva: WHO/ NMH/NHD/MNM/11. 1 (Available from: http://www. who. int/ vmnis/indicators/haemoglobin. pdf (accessed 28 April 2014)
20. Kassebaum NJ, Jasrasaria R, Naghavi M, et al. A systematic analysis of global anemia burden from 1990 to 2010. Blood 2014; 123: 615-24
21. Guralnik JM, Eisenstaedt RS, Ferrucci L, Klein HG, Woodman RC. The prevalence of anemia in persons aged 65 and older in the United States: evidence for a high rate of unexplained anemia. Blood 2004; 104: 2263-8
22. Gaskell H, Derry S, AndrewMoore R, McQuay HJ. Prevalence of anaemia in older persons: systematic review. BMC Geriatr 2008; 8: 1
23. Shander A, Knight K, Thurer R, Adamson J, Spence R. Prevalence and outcomes of anemia in surgery: a systematic review of the literature. Am J Med 2004; 116(Suppl 7A): 58S-69S
24. Beutler E, Waalen J. The definition of anemia: what is the lower limit of normal of the blood hemoglobin concentration? Blood 2006; 107: 1747-50
25. Society of Thoracic Surgeons Blood Conservation Guideline Task ForceFerraris VA, Ferraris SP, Saha SP, et al. Perioperative blood transfusion and blood conservation in cardiac surgery: the Society of Thoracic Surgeons and The Society of Cardiovascular Anesthesiologists clinical practice guideline. Ann Thorac Surg 2007; 83(5Suppl): S27-86
26. Patient Blood Management. An evidence-based approach to patient care. Available from: http://www. transfusionguide lines. org. uk/uk-transfusion-committees/national-bloodtransfusion-committee/patient-blood-management (accessed July 2014)
27. Gombotz H, Rehak PH, Shander A, Hofmann A. Blood use in elective surgery: the Austrian benchmark study. Transfusion 2007; 47: 1468-80
28. Rosencher N, Kerkkamp HE, Macheras G, et al. Orthopedic Surgery Transfusion Hemoglobin European Overview (OSTHEO) study: blood management in elective knee and hip arthroplasty in Europe. Transfusion 2003; 43: 459-69
29. Gombotz H, Rehak PH, Shander A, Hofmann A. The second Austrian benchmark study for blood use in elective surgery: results and practice change. Transfusion 2014; 54: 3178-85
30. Goodnough LT, Maniatis A, Earnshaw P, et al. Detection, evaluation, and management of preoperative anaemia in the elective orthopaedic surgical patient: NATA guidelines. Br J Anaesth 2011; 106: 13-22
31. Leal-Noval SR, Muñoz M, Asuero M, et al. Spanish Consensus Statement on alternatives to allogeneic blood transfusion: the 2013 update of the 'Seville Document'. Blood Transfus 2013; 11: 585-610
32. Kozek-LangeneckerSA, AfshariA,Albaladejo P, et al. Management of severe perioperative bleeding: guidelines from the European Society of Anaesthesiology. Eur J Anaesthesiol 2013; 30: 270-382
33. Beris P, Muñoz M, García-Erce JA, Thomas D, Maniatis A, Van der Linden P. Perioperative anaemia management: consensus statement on the role of intravenous iron. Br J Anaesth 2008; 100: 599-604
34. Muñoz M, Garcia-Erce JA, Remacha AF. Disorders of iron metabolism. Part II: iron deficiency and iron overload. J Clin Pathol 2011; 64: 287-96
35. Bhandari S. Update of a comparative analysis of cost minimization following the introduction of newly available intravenous iron therapies in hospital practice. Ther Clin Risk Manag 2011; 7: 501-9
36. Vetter TR. Tighten Your Belts! Reduce Your Transfusion Cost with Preoperative Management of Anemic Patients. San Diego, CA: Review Course Lectures, Annual Meeting International Anesthesia Research Society, 2013. Available from: http://www. iars. org/education/annual-meeting/2013/review-course-lectures/ tighten-your-belts/ (accessed August 2014)
37. Abraham I, Sun D. The cost of blood transfusion in Western Europe as estimated from six studies. Transfusion 2012; 52: 1983-8
38. Shander A, Hofmann A, Ozawa S, et al. Activity-based costs of blood transfusions in surgical patients at four hospitals. Transfusion 2010; 50: 753-65
39. Harju E. Empty iron stores as a significant risk factor in abdominal surgery. J Parent Enteral Nutr 1988; 12: 282-5
40. Izuel-Rami M, García-Erce JA, Gómez-Barrera M, Cuenca-Espiérrez J, Abad-Sazatornil R, Rabanaque-Hernández MJ. Relación de la transfusión y la ferropenia con la infección nosocomial en pacientes con fractura de cadera. Med Clin (Barc) 2008; 131: 647-52
41. Theusinger OM, Kind SL, Seifert B, Borgeat A, Gerber C, Spahn DR. Patient Blood Management in Orthopaedic surgery-a four year follow up from 2008 to 2011 at the Balgrist University Hospital in Zurich, Switzerland on transfusion requirements and blood loss. Blood Transfusion 2014; 12: 195-203
42. Díez-Lobo AI, Fisac-Martín MP, Bermejo-Aycar I, Muñoz M. Preoperative intravenous iron administration corrects anemia and reduces transfusion requirement in women undergoing abdominal hysterectomy. Transfus Altern Transfus Med 2007; 9: 114-9
43. González-Porras JR, Colado E, Conde MP, Lopez T, Nieto MJ, CorralM. An individualized pre-operative blood saving protocol can increase pre-operative haemoglobin levels and reduce the need for transfusion in elective total hip or knee arthroplasty. Transfus Med 2009; 19: 35-42
44. Bisbe E, García-Erce JA, Díez-Lobo AI, Muñoz M; Anaemia Working Group España. A multicentre comparative study on the efficacy of intravenous ferric carboxymaltose and iron sucrose for correcting preoperative anaemia in patients undergoing major elective surgery. Br J Anaesth 2011; 107: 477-8
45. Basora M, Colomina MJ, Tio M, Mora L, Salazar F, Ciercoles E. Optimizing preoperative haemoglobin with intravenous iron. Br J Anaesth 2013; 110: 488-90
46. Muñoz M, Gómez-Ramírez S, Cuenca J, et al. Very-short-term perioperative intravenous iron administration and postoperative outcome inmajor orthopedic surgery: a pooled analysis of observational data from2547 patients. Transfusion 2014; 54: 289-99
47. Steinbrüchel DA, Thomsen LL, Johansson P. Perioperative administration of intravenous iron isomaltoside 1000 (Monofer ) in non-anemic patients undergoing cardiac surgery [Abstract]. Transfus Med 2014; 14(Suppl 1): 1-8
48. Keeler B, Simpson J, Ng S, et al. The feasibility and clinical efficacy of intravenous iron administration for preoperative anaemia in patients with colorectal cancer. Colorectal Dis 2014; 16: 794-800
49. Auerbach M, Ballard H, Glaspy J. Clinical update: intravenous iron for anaemia. Lancet 2007; 369: 1502-4
50. ChertowGM, Mason PD, Vaage-Nilsen O, Ahlmén J. Update on adverse drug events associated with parenteral iron. Nephrol Dial Transplant 2006; 21: 378-82
51. Stainsby D, Jones H, Asher D, et al. SHOT Steering Group. : Serious hazards of transfusion: a decade of hemovigilance in the UK. Transfus Med Rev 2006; 20: 273-82
52. Torres S, Kuo YH, Morris K, Neibart R, Holtz JB, Davis JM. Intravenous iron following cardiac surgery does not increase the infection rate. Surg Infect (Larchmt) 2006; 7: 361-6
53. European Medicines Agency. New Recommendations to Manage Risk of Allergic Reactions with Intravenous Iron-Containing Medicines. London: European Medicines Agency. Available from: http://www. ema. europa. eu/ema/index. jsp?curl=pages/ news-and-events/news/2013/06/newsdetail-001833. jsp&mid= WC0b01ac058004d5c1 (accessed 19 September 2013)
54. Andrews SC, Robinson AK, Rodríguez-Quiñones F. Bacterial iron homeostasis. FEMS Microbiol Rev 2003; 27: 215-37
55. Wilson PD, Hutchings A, Jeans A, Macdougall IC. An analysis of the health service efficiency and patient experience with two different intravenous iron preparations in a UK anaemia clinic. J Med Econ 2013; 16: 108-14
56. Calvet X, Ruíz MÀ, Dosal A, et al. Cost-minimization analysis favours intravenous ferric carboxymaltose over ferric sucrose for the ambulatory treatment of severe iron deficiency. PLoS One 2012; 7: e45604
57. Procrit (epoetin alpha) package insert. FAD approved: November 19, 2008
58. Rosencher N, Poisson D, Albi A, Aperce M, Barré J, Samama CM. Two injections of erythropoietin correct moderate anemia in most patients awaiting orthopedic surgery. Can J Anesth 2005; 52: 160-5
59. Rineau E, Chaudet A, Carlier L, Bizot P, Lasocki S. Ferric carboxymaltose increases epoetin-a response and prevents iron deficiency before elective orthopaedic surgery. Br J Anaesth 2014; 113: 296-8
60. Corwin HL, Gettinger A, Rodriguez RM, et al. Efficacy of recombinant human erythropoietin in the critically ill patient: a randomized, double-blind, placebo-controlled trial. Crit Care Med 1999; 27: 2346-50
61. Corwin HL, Gettinger A, Pearl RG, et al. EPO Critical Care Trials Group. Efficacy of recombinant human erythropoietin in critically ill patients: a randomized controlled trial. JAMA 2002; 288: 2827-35
62. Corwin HL, Gettinger A, Fabian TC, et al. EPO Critical Care Trials Group. Efficacy and safety of epoetin alfa in critically ill patients. N Engl J Med 2007; 357: 965-76
63. Stowell CP, Jones SC, Enny C, Langholff W, Leitz G. An openlabel, randomized, parallel-group study of perioperative epoetin alfa versus standard of care for blood conservation in major elective spinal surgery: safety analysis. Spine (Phila Pa 1976) 2009; 34: 2479-85
64. Alsaleh K, Alotaibi GS, Almodaimegh HS, Aleem AA, Kouroukis CT. The use of preoperative erythropoiesis-stimulating agents (ESAs) in patients who underwent knee or hip arthroplasty: a meta-analysis of randomized clinical trials. J Arthroplasty 2013; 28: 1463-72
65. Nilsson KR, Berenholtz SM, Garrett-Mayer E, Dorman T, Klag MJ, Pronovost PJ. Association between venous thromboembolism and perioperative allogeneic transfusion. Arch Surg 2007; 142: 126-32; discussion 133
66. Kulnigg-Dabsch S, Evstatiev R, Dejaco C, Gasche C. Effect of iron therapy on platelet counts in patients with inflammatory bowel disease-associated anemia. PLoS One 2012; 7: e34520
67. Stanworth SJ, Cockburn HA, Boralessa H, Contreras M. Which groups of patients are transfused? A study of red cell usage in London and Southeast England. Vox Sang 2002; 83: 352-7
68. Carson JL, Grossman BJ, Kleinman S, et al. Red blood cell transfusion: a clinical practice guideline from the AABB. Ann Intern Med 2012; 157: 49-58
69. Leal-Noval SR, Arellano-Orden V, Maestre-Romero A, et al. Impact of national transfusion indicators on appropriate blood usage in critically ill patients. Transfusion 2011; 51: 1957-65
70. Goodnough LT. Trends in blood utilization. Transfus Med 2014; 24: 2
71. Rohde JM, Dimcheff DE, Blumberg N, et al. Health careassociated infection after red blood cell transfusion: a systematic review and meta-analysis. JAMA 2014; 311: 1317-26
72. Leal-Noval SR, Muñoz-Gómez M, Jiménez-Sánchez M, et al. Red blood cell transfusion in non-bleeding critically ill patients with moderate anemia: is there a benefit? Intensive Care Med 2013; 39: 45-53
73. Ferraris VA, Davenport DL, Saha SP, Austin PC, Zwischenberger JB. Surgical outcomes and transfusion of minimal amounts of blood in the operating room. Arch Surg 2012; 147: 49-55
74. Acheson AG, Brookes MJ, Spahn DR. Effects of allogeneic red blood cell transfusions on clinical outcomes in patients undergoing colorectal cancer surgery-Systematic review and meta-analysis. Ann Surg 2012; 256: 235-44
75. Carless PA, Henry DA, Moxey AJ, O'Connell D, Brown T, Fergusson DA. Cell salvage for minimising perioperative allogeneic blood transfusion. Cochrane Database Syst Rev 2010; 4: CD001888
76. Ker K, Prieto-Merino D, Roberts I. Systematic review, metaanalysis and meta-regression of the effect of tranexamic acid on surgical blood loss. Br J Surg 2013; 100: 1271-9
77. Basora M, Tió M, Martin N, et al. Should all patients be optimized to the same preoperative hemoglobin level to avoid transfusion in primary knee arthroplasty? Vox Sang 2014; 107: 148-52
78. Muñoz M, Ariza D, Campos A, Martín-Montañez E, Pavía J. The cost of post-operative shed blood salvage after total knee arthroplasty: an analysis of 1,093 consecutive procedures. Blood Transfus 2013; 11: 260-71