Abstract
Iron deficiency is a major problem in worldwide populations, being more alarming in surgical patients. In the presence of absolute iron deficiency (depletion of body iron), functional iron deficiency (during intense bone marrow stimulation by endogenous or exogenous factors), or iron sequestration (acute or chronic inflammatory conditions), iron-restricted erythropoiesis can develop. This systemic review was conducted to draw attention to the delicate problem of perioperative anemia, and to provide solutions to optimize the management of anemic surgical patients. Systemic reviews and meta-analyses, clinical studies and trials, case reports and international guidelines were studied, from a database of 50 articles. Bone marrow biopsy, serum ferritin levels, transferrin saturation, the mean corpuscular volume, and mean corpuscular hemoglobin concentration were used in the diagnosis of iron deficiency. There are various intravenous iron formulations, with different pharmacological profiles used for restoring iron. In surgical patients, anemia is an independent risk factor for morbidity and mortality. Therefore, anemia correction should be rapid, with parenteral iron formulations—the oral ones—being inefficient. Various studies showed the safety and efficacy of parenteral iron formulations in correcting hemoglobin levels and decreasing the blood transfusion rate, the overall mortality, the postoperative infections incidence, hospitalization days, and the general costs.
Highlights
Iron deficiency (ID), a reduction of body iron levels, is a critical problem worldwide, affecting4–30% of men, 10–43% of all women, and reaching 52% in pregnant women
Studies showed that iron deficiency complicates the management of almost one-third of surgical patients [1]
Evolution, to provide solutions for optimizing anemia, to highlight the risks it has on the patients’ evolution, to provide solutions for optimizing the the clinical surgical patients patients and and to to offer offer alternative alternative solutions solutions to to blood blood transfusion
Summary
Iron deficiency (ID), a reduction of body iron levels, is a critical problem worldwide, affecting. 4–30% of men, 10–43% of all women, and reaching 52% in pregnant women. Studies showed that iron deficiency complicates the management of almost one-third of surgical patients [1]. The prevalence of preoperative anemia varies from 26 to 75%, while after major surgery, it ascends to 90% [2]. It can occur due to excessive losses in patients with massive acute bleeding or chronic hemorrhages, malabsorption, insufficient intake in relation to increased needs, or functional deficiency due to a chronic disease (e.g., HIV, cancer). The cause can be multifactorial [3]. Iron deficiency might or might not be associated with anemia
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