by Brian P. Dunleavy
Clinical Anesthesiology, ISSUE: APRIL 2013 | VOLUME: 39:4
New York—Blood transfusions have been among the most commonly performed invasive procedures in the United States, with a significant percentage occurring perioperatively to treat anemia.
Now, there is a movement within anesthesiology to change the way anemia is managed in patients undergoing elective surgery. During a session at the 2012 PostGraduate Assembly in Anesthesiology (PGA), a panel of blood conservation specialists within the profession said that, given the risks associated with blood transfusion, it is time for a “new paradigm.”
“There is a long tradition of accepting anemia as a relatively harmless problem that can be easily corrected with transfusion,” said Aryeh Shander, MD, chief of the Departments of Anesthesiology, Critical Care Medicine, Pain Medicine and Hyperbaric Medicine at Englewood Hospital and Medical Center, in Englewood, N.J. “Transfusion for many of us is the default. That has to change.”
Studies have shown that anemia in the surgical setting is associated with significant morbidity and mortality, and the PGA panelists saw a clear need to address the condition within this patient population. However, they noted, blood transfusions carry significant risks, and too often these complications are poorly understood by clinicians—and therefore improperly explained to patients.
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