title: [Optimization of preoperative hemoglobin levels in patients without anemia and/or patients who undergo surgery with high blood loss].
abstract: To minimize allogeneic blood transfusions (ABTs) during complex surgery and surgery with considerable blood loss risk, various blood-sparing techniques are needed (multimodal approach). All surgical patients should be assessed with sufficient time to optimize hemoglobin levels and iron reserves so that the established perioperative transfusion strategy is appropriate. Even if the patient does not have anemia, improving hemoglobin levels to reduce the risk of ABT is justified in some cases, especially those in which the patient refuses a transfusion. Treatment with iron and/or erythropoietic agents might also be justified for cases that need a significant autologous blood reserve to minimize ABT during surgery with considerable blood loss.
authors: Servicio de Anestesiología y Reanimación, Área de Traumatología, Hospital Universitario Vall d'Hebron, Barcelona, España. Electronic address: mjcolomina@vhebron.net.
authors: M J
authors: MJ
authors: Colomina
authors: Servicio de Anestesiología y Reanimación, Hospital Clínic de Barcelona, Barcelona, España.
authors: M
authors: M
authors: Basora Macaya
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D017558:Elective Surgical Procedures; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D005293:Ferritins / Q000097:blood; D006397:Hematinics / Q000627:therapeutic use; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007501:Iron / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D011994:Recombinant Proteins / Q000627:therapeutic use; D013997:Time Factors
chemical_list: D006397:Hematinics; D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin; D005293:Ferritins; D007501:Iron
keywords: Anemia preoperatoria; Blood-sparing techniques; Cirugía hemorrágica; Hemoglobin; Hemoglobina; Hemorrhagic surgery; Hierro intravenoso; Intravenous iron; Optimización preoperatoria; Perioperative anemia; Preoperative optimization; Técnicas de ahorro de sangre