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Perioperative anaemia in surgical patients is well documented and has been associated with decreased quality of life and increased risk of postoperative morbidity and mortality . Perioperative blood loss and low erythropoiesis commonly increase the risk of postoperative anaemia and the risk of blood transfusion. Though blood transfusion helps to increase the haemoglobin (Hb) levels and avoid the deleterious effects of acute anaemia, several studies have suggested that blood transfusions may increase the risk of postoperative morbidity and mortality following surgery. Oral iron does not seem to be effective as demonstrated in a recent study . This has prompted a need for a safe alternative treatment..
Intravenous iron, if applied in the preoperative setting, may correct anaemia by the time of surgery and reduce the need for blood transfusion and improve outcomes. Studies have suggested that IV iron may rapidly increase Hb levels before operation and this may result in lower transfusion rates. Two recent reviews called for a randomised controlled trial (RCT) on the role of IV iron in surgery to prevent blood transfusion.
Dr. Andrew Kline
Cardiothoracic Anaesthetic at Papworth Hospital in Cambridge,
Editor-in-Chief of Anaesthesia,
Board and Council of the Association of Anaesthetists of
Great Britain and Ireland (AAGBI)