TY  - JOUR
A1  - Goodnough, Lawrence Tim
A1  - Maniatis, Alice
A1  - Earnshaw, Peter
A1  - Benoni, Goran
A1  - Beris, Photis
A1  - Bisbe, Elvira
A1  - Fergusson, Dean A.
A1  - Gombotz, Hans
A1  - Habler, Oliver
A1  - Monk, Terri G.
A1  - Ozier, Yves
A1  - Slappendel, Robert
A1  - Szpalski, Marek
T1  - Detection, evaluation, and management of preoperative anaemia in the elective orthopaedic surgical patient : NATA guidelines
T2  - British journal of anaesthesia
N2  - Previously undiagnosed anaemia is common in elective orthopaedic surgical patients and is associated with increased likelihood of blood transfusion and increased perioperative morbidity and mortality. A standardized approach for the detection, evaluation, and management of anaemia in this setting has been identified as an unmet medical need. A multidisciplinary panel of physicians was convened by the Network for Advancement of Transfusion Alternatives (NATA) with the aim of developing practice guidelines for the detection, evaluation, and management of preoperative anaemia in elective orthopaedic surgery. A systematic literature review and critical evaluation of the evidence was performed, and recommendations were formulated according to the method proposed by the Grades of Recommendation Assessment, Development and Evaluation (GRADE) Working Group. We recommend that elective orthopaedic surgical patients have a haemoglobin (Hb) level determination 28 days before the scheduled surgical procedure if possible (Grade 1C). We suggest that the patient's target Hb before elective surgery be within the normal range, according to the World Health Organization criteria (Grade 2C). We recommend further laboratory testing to evaluate anaemia for nutritional deficiencies, chronic renal insufficiency, and/or chronic inflammatory disease (Grade 1C). We recommend that nutritional deficiencies be treated (Grade 1C). We suggest that erythropoiesis-stimulating agents be used for anaemic patients in whom nutritional deficiencies have been ruled out, corrected, or both (Grade 2A). Anaemia should be viewed as a serious and treatable medical condition, rather than simply an abnormal laboratory value. Implementation of anaemia management in the elective orthopaedic surgery setting will improve patient outcomes.
KW  - anaemia
KW  - blood transfusion
KW  - orthopaedic surgery
KW  - preoperative assessment
KW  - preoperative preparation
Y1  - 2011
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/26583
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-265832
SN  - 1471-6771
SN  - 0007-0912
N1  - © The Author [2011]. Published by Oxford University Press on behalf of the British Journal of Anaesthesia.

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VL  - 106
IS  - 1
SP  - 13
EP  - 22
PB  - Oxford Univ. Press
CY  - Oxford [u.a.]
ER  -