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  1. Fulltext Getting patient blood management Pillar 1 right in the Asia-Pacific: a call for action
    Abdullah HR, Ang AL, Froessler B, Hofmann A, Jang JH, Kim YW, et al.
    Singapore Med J, 2020 Jun;61(6):287-296.
    PMID: 31044255 DOI: 10.11622/smedj.2019037
    Preoperative anaemia is common in the Asia-Pacific. Iron deficiency anaemia (IDA) is a risk factor that can be addressed under patient blood management (PBM) Pillar 1, leading to reduced morbidity and mortality. We examined PBM implementation under four different healthcare systems, identified challenges and proposed several measures: (a) Test for anaemia once patients are scheduled for surgery. (b) Inform patients about risks of preoperative anaemia and benefits of treatment. (c) Treat IDA and replenish iron stores before surgery, using intravenous iron when oral treatment is ineffective, not tolerated or when rapid iron replenishment is needed; transfusion should not be the default management. (d) Harness support from multiple medical disciplines and relevant bodies to promote PBM implementation. (e) Demonstrate better outcomes and cost savings from reduced mortality and morbidity. Although PBM implementation may seem complex and daunting, it is feasible to start small. Implementing PBM Pillar 1, particularly in preoperative patients, is a sensible first step regardless of the healthcare setting.
  2. Fulltext Recommendations From the International Consensus Conference on Anemia Management in Surgical Patients (ICCAMS)
    Shander A, Corwin HL, Meier J, Auerbach M, Bisbe E, Blitz J, et al.
    Ann Surg, 2023 Apr 01;277(4):581-590.
    PMID: 36134567 DOI: 10.1097/SLA.0000000000005721
    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.

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