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Canadian Journal of Anesthesia/Journal canadien d'anesthésie

Erschienen in:

28.11.2023 | Review Article/Brief Review

Postoperative anemia in cardiac surgery patients: a narrative review

verfasst von: Michelle M. Li, BMSc, Sarah Miles, PhD, Jeannie Callum, MD, FRCPC, Yulia Lin, MD, FRCPC, Keyvan Karkouti, MD, MSc, FRCPC, Justyna Bartoszko, MD, MSc, FRCPC

Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Ausgabe 3/2024

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Abstract

Purpose

Anemia reduces the blood’s ability to carry and deliver oxygen. Following cardiac surgery, anemia is very common and affects up to 90% of patients. Nevertheless, there is a paucity of data examining the prognostic value of postoperative anemia. In this narrative review, we present findings from the relevant literature on postoperative anemia in cardiac surgery patients, focusing on the incidence, risk factors, and prognostic value of postoperative anemia. We also explore the potential utility of postoperative anemia as a therapeutic target to improve clinical outcomes.

Source

We conducted a targeted search of MEDLINE, Embase, and the Cochrane Database of Systematic Reviews up to September 2022, using a combination of search terms including postoperative (post-operative), perioperative (peri-operative), anemia (anaemia), and cardiac surgery.

Principal findings

The reported incidence of postoperative anemia varied from 29% to 94% across the studies, likely because of variations in patient inclusion criteria and classification of postoperative anemia. Nonetheless, the weight of the evidence suggests that postoperative anemia is common and is an independent risk factor for adverse postoperative outcomes such as acute kidney injury, stroke, mortality, and functional outcomes.

Conclusions

In cardiac surgery patients, postoperative anemia is a common and prognostically important risk factor for postoperative morbidity and mortality. Nevertheless, there is a lack of data on whether active management of postoperative anemia is feasible or effective in improving patient outcomes.

Musallam KM, Tamim HM, Richards T, et al. Preoperative anaemia and postoperative outcomes in non-cardiac surgery: a retrospective cohort study. Lancet 2011; 378: 1396–407. https://doi.org/10.1016/s0140-6736(11)61381-0CrossRefPubMed

Hung M, Besser M, Sharples LD, Nair SK, Klein AA. The prevalence and association with transfusion, intensive care unit stay and mortality of pre-operative anaemia in a cohort of cardiac surgery patients. Anaesthesia 2011; 66: 812–8. https://doi.org/10.1111/j.1365-2044.2011.06819.xCrossRefPubMed

Gómez-Ramirez S, Jericó C, Muñoz M. Perioperative anemia: prevalence, consequences and pathophysiology. Transfus Apher Sci 2019; 58: 369–74. https://doi.org/10.1016/j.transci.2019.06.011CrossRefPubMed

Kulier A, Levin J, Moser R, et al. Impact of preoperative anemia on outcome in patients undergoing coronary artery bypass graft surgery. Circulation 2007; 116: 471–9. https://doi.org/10.1161/circulationaha.106.653501CrossRefPubMed

Padmanabhan H, Brookes MJ, Nevill AM, Luckraz H. Association between anemia and blood transfusion with long-term mortality after cardiac surgery. Ann Thorac Surg 2019; 108: 687–92. https://doi.org/10.1016/j.athoracsur.2019.04.044CrossRefPubMed

Dunkelgrun M, Hoeks SE, Welten GM, et al. Anemia as an independent predictor of perioperative and long-term cardiovascular outcome in patients scheduled for elective vascular surgery. Am J Cardiol 2008; 101: 1196–200. https://doi.org/10.1016/j.amjcard.2007.11.072CrossRefPubMed

Ripoll JG, Smith MM, Hanson AC, et al. Sex-specific associations between preoperative anemia and postoperative clinical outcomes in patients undergoing cardiac surgery. Anesth Analg 2021; 132: 1101–11. https://doi.org/10.1213/ane.0000000000005392CrossRefPubMedPubMedCentral

Gupta PK, Sundaram A, MacTaggart JN, et al. Preoperative anemia is an independent predictor of postoperative mortality and adverse cardiac events in elderly patients undergoing elective vascular operations. Ann Surg 2013; 258: 1096–102. https://doi.org/10.1097/sla.0b013e318288e957CrossRefPubMed

Padmanabhan H, Aktuerk D, Brookes MJ, et al. Anemia in cardiac surgery: next target for mortality and morbidity improvement? Asian Cardiovasc Thorac Ann 2016; 24: 12–7. https://doi.org/10.1177/0218492315618032CrossRefPubMed

10.

Fowler AJ, Ahmad T, Phull MK, Allard S, Gillies MA, Pearse RM. Meta-analysis of the association between preoperative anaemia and mortality after surgery. Br J Surg 2015; 102: 1314–24. https://doi.org/10.1002/bjs.9861CrossRefPubMed

11.

Baron DM, Hochrieser H, Posch M, et al. Preoperative anaemia is associated with poor clinical outcome in non-cardiac surgery patients. Br J Anaesth 2014; 113: 416–23. https://doi.org/10.1093/bja/aeu098CrossRefPubMed

12.

Greenky M, Gandhi K, Pulido L, Restrepo C, Parvizi J. Preoperative Anemia in total joint arthroplasty: is it associated with periprosthetic joint infection? Clin Orthop Relat Res 2012; 470: 2695–701. https://doi.org/10.1007/s11999-012-2435-zCrossRefPubMedPubMedCentral

13.

De Santo L, Romano G, Della Corte A, et al. Preoperative anemia in patients undergoing coronary artery bypass grafting predicts acute kidney injury. J Thorac Cardiovasc Surg 2009; 138: 965–70. https://doi.org/10.1016/j.jtcvs.2009.05.013CrossRefPubMed

14.

Saager L, Turan A, Reynolds LF, Dalton JE, Mascha EJ, Kurz A. The association between preoperative anemia and 30-day mortality and morbidity in noncardiac surgical patients. Anesth Analg 2013; 117: 909–15. https://doi.org/10.1213/ane.0b013e31828b347dCrossRefPubMed

15.

Sakr Y, Lobo S, Knuepfer S, et al. Anemia and blood transfusion in a surgical intensive care unit. Crit Care 2010; 14: R92. https://doi.org/10.1186/cc9026CrossRefPubMedPubMedCentral

16.

Joshi SS, George A, Manasa D, Savita HM, Krishna PT, Jagadeesh AM. Propensity-matched analysis of association between preoperative anemia and in-hospital mortality in cardiac surgical patients undergoing valvular heart surgeries. Ann Card Anaesth 2015; 18: 373–9. https://doi.org/10.4103/0971-9784.159808CrossRefPubMedPubMedCentral

17.

Ranucci M, Di Dedda U, Castelvecchio S, Menicanti L, Frigiola A, Pelissero G. Impact of preoperative anemia on outcome in adult cardiac surgery: a propensity-matched analysis. Ann Thorac Surg 2012; 94: 1134–41. https://doi.org/10.1016/j.athoracsur.2012.04.042CrossRefPubMed

18.

Hazen YJ, Noordzij PG, Gerritse BM, et al. Preoperative anaemia and outcome after elective cardiac surgery: a Dutch national registry analysis. Br J Anaesth 2022; 128: 636–43. https://doi.org/10.1016/j.bja.2021.12.016CrossRefPubMed

19.

Dunne JR, Malone D, Tracy JK, Gannon C, Napolitano LM. Perioperative anemia: an independent risk factor for infection, mortality, and resource utilization in surgery. J Surg Res 2002; 102: 237–44. https://doi.org/10.1006/jsre.2001.6330CrossRefPubMed

20.

Carrascal Y, Maroto L, Rey J, et al. Impact of preoperative anemia on cardiac surgery in octogenarians. Interact Cardiovasc Thorac Surg 2010; 10: 249–55. https://doi.org/10.1510/icvts.2009.220160CrossRefPubMed

21.

Miceli A, Romeo F, Glauber M, de Siena PM, Caputo M, Angelini GD. Preoperative anemia increases mortality and postoperative morbidity after cardiac surgery. J Cardiothorac Surg 2014; 9: 137. https://doi.org/10.1186/1749-8090-9-137CrossRefPubMedPubMedCentral

22.

Jabagi H, Boodhwani M, Tran DT, Sun L, Wells G, Rubens FD. The effect of preoperative anemia on patients undergoing cardiac surgery: a propensity-matched analysis. Semin Thorac Cardiovasc Surg 2019; 31: 157–63. https://doi.org/10.1053/j.semtcvs.2018.09.015CrossRefPubMed

23.

Padmanabhan H, Siau K, Curtis J, et al. Preoperative anemia and outcomes in cardiovascular surgery: systematic review and meta-analysis. Ann Thorac Surg 2019; 108: 1840–8. https://doi.org/10.1016/j.athoracsur.2019.04.108CrossRefPubMed

24.

Hogervorst EK, Rosseel PM, van de Watering LM, et al. Intraoperative anemia and single red blood cell transfusion during cardiac surgery: an assessment of postoperative outcome including patients refusing blood transfusion. J Cardiothorac Vasc Anesth 2016; 30: 363–72. https://doi.org/10.1053/j.jvca.2015.10.021CrossRefPubMed

25.

Baethge C, Goldbeck-Wood S, Mertens S. SANRA—a scale for the quality assessment of narrative review articles. Res Integr Peer Rev 2019; 4: 5. https://doi.org/10.1186/s41073-019-0064-8CrossRefPubMedPubMedCentral

26.

Cui R, Li F, Shao J, et al. Postoperative anemia is a risk factor for acute kidney injury after open aorta and vena cava surgeries. PLoS One 2020; 15: e0240243. https://doi.org/10.1371/journal.pone.0240243CrossRefPubMedPubMedCentral

27.

Westenbrink BD, Kleijn L, de Boer RA, et al. Sustained postoperative anaemia is associated with an impaired outcome after coronary artery bypass graft surgery: insights from the IMAGINE trial. Heart 2011; 97: 1590–6. https://doi.org/10.1136/heartjnl-2011-300118CrossRefPubMed

28.

Vlot EA, Verwijmeren L, van de Garde EM, Kloppenburg GT, van Dongen EP, Noordzij PG. Intra-operative red blood cell transfusion and mortality after cardiac surgery. BMC Anesthesiol 2019; 19: 65. https://doi.org/10.1186/s12871-019-0738-2CrossRefPubMedPubMedCentral

29.

Muñoz M, Acheson AG, Bisbe E, et al. An international consensus statement on the management of postoperative anaemia after major surgical procedures. Anaesthesia 2018; 73: 1418–31. https://doi.org/10.1111/anae.14358CrossRefPubMedPubMedCentral

30.

Muñoz M, García-Erce JA, Remacha ÁF. Disorders of iron metabolism. Part II: iron deficiency and iron overload. J Clin Pathol 2011; 64: 287–96. https://doi.org/10.1136/jcp.2010.086991CrossRefPubMed

31.

van Iperen CE, Gaillard CA, Kraaijenhagen RJ, Braam BG, Marx JJ, van de Wiel A. Response of erythropoiesis and iron metabolism to recombinant human erythropoietin in intensive care unit patients. Crit Care Med 2000; 28: 2773–8. https://doi.org/10.1097/00003246-200008000-00015CrossRefPubMed

32.

van Iperen CE, Kraaijenhagen RJ, Biesma DH, Beguin Y, Marx JJ, van de Wiel A. Iron metabolism and erythropoiesis after surgery. Br J Surg 2003; 85: 41–5. https://doi.org/10.1046/j.1365-2168.1998.00571.xCrossRef

33.

World Health Organization. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Available from URL: WHO_NMH_NHD_MNM_11.1_eng.pdf (accessed August 2023).

34.

Smoor RM, Rettig TC, Vernooij LM, et al. Postoperative anaemia and disability-free survival in older cardiac surgery patients. Br J Anaesth 2022; 129: e27–9. https://doi.org/10.1016/j.bja.2022.04.017CrossRefPubMed

35.

Oprea AD, Del Rio JM, Cooter M, et al. Pre- and postoperative anemia, acute kidney injury, and mortality after coronary artery bypass grafting surgery: a retrospective observational study. Can J Anesth 2018; 65: 46–59. https://doi.org/10.1007/s12630-017-0991-0CrossRefPubMed

36.

Oliver E, Carrio ML, Rodríguez-Castro D, et al. Relationships among haemoglobin level, packed red cell transfusion and clinical outcomes in patients after cardiac surgery. Intensive Care Med 2009; 35: 1548–55. https://doi.org/10.1007/s00134-009-1526-0CrossRefPubMed

37.

Ranucci M, La Rovere MT, Castelvecchio S, et al. Postoperative anemia and exercise tolerance after cardiac operations in patients without transfusion: what hemoglobin level is acceptable? Ann Thorac Surg 2011; 92: 25–31. https://doi.org/10.1016/j.athoracsur.2011.02.058CrossRefPubMed

38.

Zhou L, Liu X, Yan M, et al. Postoperative nadir hemoglobin and adverse outcomes in patients undergoing on-pump cardiac operation. Ann Thorac Surg 2021; 112: 708–16. https://doi.org/10.1016/j.athoracsur.2021.01.016CrossRefPubMed

39.

Bahrainwala ZS, Grega MA, Hogue CW, et al. Intraoperative hemoglobin levels and transfusion independently predict stroke after cardiac operations. Ann Thorac Surg 2011; 91: 1113–8. https://doi.org/10.1016/j.athoracsur.2010.12.049CrossRefPubMedPubMedCentral

40.

Mazer CD, Whitlock RP, Fergusson DA, et al. Restrictive or liberal red-cell transfusion for cardiac surgery. N Engl J Med 2017; 377: 2133–44. https://doi.org/10.1056/nejmoa1711818CrossRefPubMed

41.

Rouleau JL, Warnica WJ, Baillot R, et al. Effects of angiotensin-converting enzyme inhibition in low-risk patients early after coronary artery bypass surgery. Circulation 2008; 117: 24–31. https://doi.org/10.1161/circulationaha.106.685073CrossRefPubMed

42.

Smilowitz NR, Gupta N, Ramakrishna H, Guo Y, Berger JS, Bangalore S. Perioperative major adverse cardiovascular and cerebrovascular events associated with noncardiac surgery. JAMA Cardiol 2017; 2: 181–7. https://doi.org/10.1001/jamacardio.2016.4792CrossRefPubMedPubMedCentral

43.

Glaser N, Persson M, Franco‐Cereceda A, Sartipy U. Cause of death after surgical aortic valve replacement: SWEDEHEART observational study. J Am Heart Assoc 2021; 10: e022627. https://doi.org/10.1161/jaha.121.022627CrossRefPubMedPubMedCentral

44.

Němec P, Fila P, Štěrba J, Černošek J. Value of autopsy in cardiac surgery. Cor Vasa 2015; 57: e91–4. https://doi.org/10.1016/j.crvasa.2015.03.001CrossRef

45.

Chan PG, Seese L, Aranda-Michel E, et al. Operative mortality in adult cardiac surgery: is the currently utilized definition justified? J Thorac Dis 2021; 13: 5582–91. https://doi.org/10.21037/jtd-20-2213CrossRefPubMedPubMedCentral

46.

Sabatine MS, Morrow DA, Giugliano RP, et al. Association of hemoglobin levels with clinical outcomes in acute coronary syndromes. Circulation 2005; 111: 2042–9. https://doi.org/10.1161/01.cir.0000162477.70955.5fCrossRefPubMed

47.

Meer P van der, Groenveld HF, Januzzi JL, van Veldhuisen DJ. Erythropoietin treatment in patients with chronic heart failure: a meta-analysis. Heart 2009; 95: 1309–14. https://doi.org/10.1136/hrt.2008.161091CrossRefPubMed

48.

van Straten AH, Soliman Hamad MA, van Zundert AJ, Martens EJ, Schönberger JP, de Wolf AM. Preoperative hemoglobin level as a predictor of survival after coronary artery bypass grafting. Circulation 2009; 120: 118–25. https://doi.org/10.1161/circulationaha.109.854216CrossRefPubMed

49.

Ranucci M, Conti D, Castelvecchio S, et al. Hematocrit on cardiopulmonary bypass and outcome after coronary surgery in nontransfused patients. Ann Thorac Surg 2010; 89: 11–7. https://doi.org/10.1016/j.athoracsur.2009.07.078CrossRefPubMed

50.

Padda J, Khalid K, Hitawala G, et al. Acute anemia and myocardial infarction. Cureus 2021; 13: e17096. https://doi.org/10.7759/cureus.17096CrossRefPubMedPubMedCentral

51.

Hasin T, Sorkin A, Markiewicz W, Hammerman H, Aronson D. Prevalence and prognostic significance of transient, persistent, and new-onset anemia after acute myocardial infarction. Am J Cardiol 2009; 104: 486–91. https://doi.org/10.1016/j.amjcard.2009.03.066CrossRefPubMed

52.

Mahendiran T, Nanchen D, Gencer B, et al. Prognosis of patients with chronic and hospital-acquired anaemia after acute coronary syndromes. J Cardiovasc Transl Res 2020; 13: 618–28. https://doi.org/10.1007/s12265-019-09934-wCrossRefPubMed

53.

Kramer RS, Herron CR, Groom RC, Brown JR. Acute kidney injury subsequent to cardiac surgery. J Extra Corpor Technol 2015; 47: 16–28.CrossRefPubMedPubMedCentral

54.

Boening A, Boedeker RH, Scheibelhut C, Rietzschel J, Roth P, Schönburg M. Anemia before coronary artery bypass surgery as additional risk factor increases the perioperative risk. Ann Thorac Surg 2011; 92: 805–10. https://doi.org/10.1016/j.athoracsur.2011.02.076CrossRefPubMed

55.

Matsuda S, Fukui T, Shimizu J, Takao A, Takanashi S, Tomoike H. Associations between preoperative anemia and outcomes after off-pump coronary artery bypass grafting. Ann Thorac Surg 2013; 95: 854–60. https://doi.org/10.1016/j.athoracsur.2012.10.005CrossRefPubMed

56.

Shavit L, Hitti S, Silberman S, et al. Preoperative hemoglobin and outcomes in patients with CKD undergoing cardiac surgery. Clin J Am Soc Nephrol 2014; 9: 1536–44. https://doi.org/10.2215/cjn.00110114CrossRefPubMedPubMedCentral

57.

Karkouti K, Wijeysundera DN, Yau TM, McCluskey SA, Van Rensburg A, Beattie WS. The influence of baseline hemoglobin concentration on tolerance of anemia in cardiac surgery. Transfusion 2008; 48: 666–72. https://doi.org/10.1111/j.1537-2995.2007.01590.xCrossRefPubMed

58.

Elmistekawy E, Rubens FD, Hudson C, et al. Preoperative anaemia is a risk factor for mortality and morbidity following aortic valve surgery. Eur J Cardiothorac Surg 2013; 44: 1051–5. https://doi.org/10.1093/ejcts/ezt143CrossRefPubMed

59.

Kim C, Connell H, McGeorge A, Hu R. Prevalence of preoperative anaemia in patients having first-time cardiac surgery and its impact on clinical outcome. A retrospective observational study. Perfusion 2015; 30: 277–83. https://doi.org/10.1177/0267659114542457CrossRefPubMed

60.

Karkouti K, Wijeysundera DN, Beattie WS. Risk associated with preoperative anemia in cardiac surgery. Circulation 2008; 117: 487–84. https://doi.org/10.1161/circulationaha.107.718353CrossRef

61.

Williams M, He X, Rankin S, Slaughter MS, Gammie JS. Preoperative hematocrit is a powerful predictor of adverse outcomes in coronary artery bypass graft surgery: a report from the Society of Thoracic Surgeons Adult Cardiac Surgery Database. Ann Thorac Surg 2013; 96: 1628–34. https://doi.org/10.1016/j.athoracsur.2013.06.030CrossRefPubMed

62.

Acute Kidney Injury Work Group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl 2012; 2: https://doi.org/10.1038/kisup.2012.1

63.

Mehta RL, Kellum JA, Shah SV, et al. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care 2007; 11: R31. https://doi.org/10.1186/cc5713CrossRefPubMedPubMedCentral

64.

Brinson Z, Tang VL, Finlayson E. Postoperative functional outcomes in older adults. Curr Surg Rep 2016; 4: 21. https://doi.org/10.1007/s40137-016-0140-7CrossRefPubMedPubMedCentral

65.

Onem Y, Terekeci H, Kucukardali Y, et al. Albumin, hemoglobin, body mass index, cognitive and functional performance in elderly persons living in nursing homes. Arch Gerontol Geriatr 2010; 50: 56–9. https://doi.org/10.1016/j.archger.2009.01.010CrossRefPubMed

66.

Artz AS. Anemia and the frail elderly. Semin Hematol 2008; 45: 261–6. https://doi.org/10.1053/j.seminhematol.2008.06.002CrossRefPubMed

67.

Bowling CB, Muntner R, Bradbury BD, et al. Low hemoglobin levels and recurrent falls in U.S. men and women: prospective findings from the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort. Am J Med Sci 2013; 345: 446–54. https://doi.org/10.1097/maj.0b013e3182638364CrossRefPubMedPubMedCentral

68.

Thaler-Kall K, Döring A, Peters A, et al. Association between anemia and falls in community-dwelling older people: cross-sectional results from the KORA-Age study. BMC Geriatr 2014; 14: 29. https://doi.org/10.1186/1471-2318-14-29CrossRefPubMedPubMedCentral

69.

Juárez-Cedillo T, Basurto-Acevedo L, Vega-García S, et al. Prevalence of anemia and its impact on the state of frailty in elderly people living in the community: SADEM study. Ann Hematol 2014; 93: 2057–62. https://doi.org/10.1007/s00277-014-2155-4CrossRefPubMed

70.

Thein M, Ershler WB, Artz AS, et al. Diminished quality of life and physical function in community-dwelling elderly with anemia. Medicine 2009; 88: 107–14. https://doi.org/10.1097/MD.0b013e31819d89d5CrossRefPubMed

71.

Agnihotri P, Telfer M, Butt Z, et al. Chronic anemia and fatigue in elderly patients: results of a randomized, double-blind, placebo-controlled, crossover exploratory study with epoetin alfa. J Am Geriatr Soc 2007; 55: 1557–65. https://doi.org/10.1111/j.1532-5415.2007.01357.xCrossRefPubMed

72.

den Elzen WP, Willems JM, Westendorp RG, de Craen AJ, Assendelft WJ, Gussekloo J. Effect of anemia and comorbidity on functional status and mortality in old age: results from the Leiden 85-plus study. CMAJ 2009; 181: 151–7. https://doi.org/10.1503/cmaj.090040CrossRef

73.

Beghé C, Wilson A, Ershler WB. Prevalence and outcomes of anemia in geriatrics: a systematic review of the literature. Am J Med 2004; 116: 3–10. https://doi.org/10.1016/j.amjmed.2003.12.009CrossRef

74.

Pel EL, van Wijngaarden E, van Dongen EP, Noordzij PG. Anesthesia geriatric evaluation (AGE): a care-ethical perspective of a multi-disciplinary approach for tailored preoperative interventions. Gerontol Geriatr Med 2019; 5: https://doi.org/10.1177/2333721419876126

75.

CADTH. CADTH common drug review: clinical review report; 2017. Available from URL: https://www.ncbi.nlm.nih.gov/books/NBK533972/pdf/Bookshelf_NBK533972.pdf (accessed August 2023).

76.

Murphy GJ, Reeves BC, Rogers CA, Rizvi SI, Culliford L, Angelini GD. Increased mortality, postoperative morbidity, and cost after red blood cell transfusion in patients having cardiac surgery. Circulation 2007; 116: 2544–52. https://doi.org/10.1161/circulationaha.107.698977CrossRefPubMed

77.

Hajjar LA, Vincent JL, Galas FR, et al. Transfusion requirements after cardiac surgery: the TRACS randomized controlled trial. JAMA 2010; 304: 1559–67. https://doi.org/10.1001/jama.2010.1446CrossRefPubMed

78.

Koch CG, Li L, Duncan AI, et al. Morbidity and mortality risk associated with red blood cell and blood-component transfusion in isolated coronary artery bypass grafting. Crit Care Med 2006; 34: 1608–16. https://doi.org/10.1097/01.ccm.0000217920.48559.d8CrossRefPubMed

79.

Tolkien Z, Stecher L, Mander AP, Pereira DI, Powell JJ. Ferrous sulfate supplementation causes significant gastrointestinal side-effects in adults: a systematic review and meta-analysis. PLoS One 2015; 10: e0117383. https://doi.org/10.1371/journal.pone.0117383CrossRefPubMedPubMedCentral

80.

Bloor SR, Schutte R, Hobson AR. Oral iron supplementation—gastrointestinal side effects and the impact on the gut microbiota. Microbiol Res 2021; 12: 491–502. https://doi.org/10.3390/microbiolres12020033CrossRef

81.

Stoffel NU, Zeder C, Brittenham GM, Moretti D, Zimmermann MB. Iron absorption from supplements is greater with alternate day than with consecutive day dosing in iron-deficient anemic women. Haematologica 2020; 105: 1232–9. https://doi.org/10.3324/haematol.2019.220830CrossRefPubMedPubMedCentral

82.

Stoffel NU, Cercamondi CI, Brittenham G, et al. Iron absorption from oral iron supplements given on consecutive versus alternate days and as single morning doses versus twice-daily split dosing in iron-depleted women: two open-label, randomised controlled trials. Lancet Haematol 2017; 4: e524–33. https://doi.org/10.1016/s2352-3026(17)30182-5CrossRefPubMed

83.

Cançado RD, Muñoz M. Intravenous iron therapy: how far have we come? Rev Bras Hematol Hemoter 2011; 33: 461–9. https://doi.org/10.5581/1516-8484.20110123CrossRefPubMedPubMedCentral

Titel: Postoperative anemia in cardiac surgery patients: a narrative review
verfasst von: Michelle M. Li, BMSc
Sarah Miles, PhD
Jeannie Callum, MD, FRCPC
Yulia Lin, MD, FRCPC
Keyvan Karkouti, MD, MSc, FRCPC
Justyna Bartoszko, MD, MSc, FRCPC
Publikationsdatum: 28.11.2023
Verlag: Springer International Publishing
Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Ausgabe 3/2024
Print ISSN: 0832-610X
Elektronische ISSN: 1496-8975
DOI: https://doi.org/10.1007/s12630-023-02650-9

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Postoperative anemia in cardiac surgery patients: a narrative review