Anemia is frequently seen in patients undergoing surgery, and patients with preoperative anemia are more likely to receive perioperative allogeneic blood transfusions than patients with normal hemoglobin levels. Allogeneic blood transfusions are associated with an increase in the rate of postoperative complications.
Evaluation of anemia should be performed in the preoperative period and begins with taking a detailed history and physical examination. All efforts must be used to correct anemia or reduce blood loss during surgery to avoid allogeneic blood transfusion. In this module we will discuss many scenarios commonly faced in perioperative practice.
After completing the module, the participant should be able to:
- Identify the risks of anemia and blood transfusion in the perioperative period. [MK]
- Formulate an evaluation of anemia in the preoperative setting. [MK, PB]
- Describe specific management strategies for several common causes of anemia. [MK]
- Assess appropriate perioperative transfusion thresholds. [MK, PB]
- Summarize available modalities to reduce the risk of allogeneic blood exposure in the perioperative period. [MK]
- Formulate an evaluation of anemia in the postoperative setting. [MK]
Accreditation Council for Graduate Medical Education General Competency Assignments
PC Patient Care
MK Medical Knowledge
IC Interpersonal & Communication Skills
SB Systems-Based Practice
PB Practice-Based Learning & Improvement
Source: Accreditation Council for Graduate Medical Education. Common Program Requirements: General Competencies. Available at: http://www.acgme.org/outcome/comp/GeneralCompetenciesStandards21307.pdf. Published: September 28, 1999. Accessed December 4, 2009.
The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.
Credit Designation Statement: The Johns Hopkins University School of Medicine designates this educational activity for a maximum of 2 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Release date: April 30, 2010. Expiration date: April 30, 2012.
*Medical Director, Internal Medicine Preoperative Center (IMPACT), Blood Management, Department of Hospital Medicine, Cleveland Clinic Foundation, Cleveland Ohio.
†Medical Director, Hospital Medicine Program, Vice Chairman, Department of Medicine, Baptist Hospital of Miami, Miami, Florida.
Disclaimer: The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of Johns Hopkins University School of Medicine name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combination of drugs, including indications, contraindications, warnings and adverse effects before administering pharmacologic therapy to patients.
Supported by an educational grant from Merck & Co., Inc.