Pathway for preoperative management of anaemia in adult elective surgical patients

Rationale

PREVENNT study showed that where Hb > 90g/L, Ferinject given 14 days preop increased Hb by 4.7 g/L, but did not alter transfusion, mortality or complications.

Oral Iron can increase preop Hb by up to 17 g/L in Fe deficient patients but requires at least 4 weeks therapy and may not be tolerated.

Decisions to cancel on the basis of anaemia require a patient centred approach, with consideration of patient size/red cell mass, likelihood of transfusion/nature of surgery, likelihood of haematinic treatment success and patient wishes.