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Recommendations From the International Consensus Conference on Anemia Management in Surgical Patients (ICCAMS)

Shander A 1 , Corwin HL 2 , Meier J 3 , Auerbach M 4 , Bisbe E 5 , Blitz J 6 Show all authors , Erhard J 7 , Faraoni D 8 , Farmer SL 9 , Frank SM 10 , Girelli D 11 , Hall T 12 , Hardy JF 5 , Hofmann A 13 , Lee CK 14 , Leung TW 15 , Ozawa S 16 , Sathar J 17 , Spahn DR 18 , Torres R 19 , Warner MA 20 , Muñoz M 21

Affiliations 

  • 1 Department of Anesthesiology, Critical Care Medicine, Hyperbaric Medicine and Pain Management, Englewood Hospital and Medical Center, Englewood, NJ
  • 2 Critical Care Medicine, Geisinger Health System, Danville, PA
  • 3 Clinic of Anaesthesiology and Intensive Care Medicine, Kepler University Hospital, Linz, Austria
  • 4 School of Medicine, Georgetown University, Washington, DC
  • 5 Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis (NATA), Brussels, Belgium
  • 6 Department of Anesthesiology, Duke University School of Medicine, Durham, NC
  • 7 Department of Surgery, Evangelisches Klinikum Niederrhein, Duisburg, Germany
  • 8 Department of Anesthesiology, Perioperative and Pain Medicine, Arthur S. Keats Division of Pediatric Cardiovascular Anesthesia, Texas Children's Hospital, Baylor College of Medicine, Houston, TX
  • 9 Discipline of Surgery, Medical School, The University of Western Australia, Perth, Australia
  • 10 Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medical Institutions, Baltimore, MD
  • 11 Department of Medicine, University of Verona and Integrated University Hospital of Verona, Verona, Italy
  • 12 Anemia Management, Accumen Inc., San Diego, CA
  • 13 Discipline of Surgery, Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia
  • 14 Hong Kong Red Cross Blood Transfusion Service, Hong Kong SAR, China
  • 15 Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Hong Kong SAR, China
  • 16 Patient Blood Management, Accumen Inc., San Diego, CA
  • 17 Department of Haematology, Ampang Hospital, Ampang, Malaysia
  • 18 Institute of Anesthesiology, University and University Hospital of Zurich, Zurich, Switzerland
  • 19 Section of Hematology, Department of Internal Medicine, Makati Medical Center, Makati City, Philippines
  • 20 Department of Anesthesiology and Perioperative Medicine, Division of Critical Care Medicine, Mayo Clinic, Rochester, MN
  • 21 Department of Surgical Specialties, Biochemistry and Immunology, School of Medicine, University of Málaga, Málaga, Spain
Ann Surg, 2023 Apr 01;277(4):581-590.
PMID: 36134567 DOI: 10.1097/SLA.0000000000005721

Abstract

BACKGROUND: Perioperative anemia has been associated with increased risk of red blood cell transfusion and increased morbidity and mortality after surgery. The optimal approach to the diagnosis and management of perioperative anemia is not fully established.

OBJECTIVE: To develop consensus recommendations for anemia management in surgical patients.

METHODS: An international expert panel reviewed the current evidence and developed recommendations using modified RAND Delphi methodology.

RESULTS: The panel recommends that all patients except those undergoing minor procedures be screened for anemia before surgery. Appropriate therapy for anemia should be guided by an accurate diagnosis of the etiology. The need to proceed with surgery in some patients with anemia is expected to persist. However, early identification and effective treatment of anemia has the potential to reduce the risks associated with surgery and improve clinical outcomes. As with preoperative anemia, postoperative anemia should be treated in the perioperative period.

CONCLUSIONS: Early identification and effective treatment of anemia has the potential to improve clinical outcomes in surgical patients.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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