Lanigan Megan, Wilkey Andrew
University of Minnesota, Department of Anesthesiology, Minneapolis, Minnesota, USA.
Curr Opin Anaesthesiol. 2023 Feb 1;36(1):89-95. doi: 10.1097/ACO.0000000000001214. Epub 2022 Nov 23.
The purpose of this review is to evaluate the current recommendations for management of perioperative anaemia in patients undergoing thoracic surgery, present the impact of anaemia on outcomes in this patient population and suggest an algorithm for evaluating and treating anaemia preoperatively.
Anaemia is a common medical issue noted preoperatively in patients presenting for thoracic surgery and carries significant morbidity. Preoperative anaemia increases the likelihood of receiving a perioperative transfusion, which represents a significant risk factor for morbidity and reduced disease-free survival in lung cancer patients presenting for thoracic surgery. It is also associated with longer hospital lengths of stay and increased risk for reoperation following lung transplantation. An algorithm-based approach to management of anaemia is beneficial and treatment with iron has been shown to reduce transfusions.
Patients undergoing thoracic surgery have a high incidence of preoperative anaemia that increases the risk of transfusion and postoperative morbidity. Preoperative evaluation and tailored treatment based on the underlying cause of anaemia reduces the incidence of anaemia prior to surgery and decreases transfusion rates.
本综述旨在评估目前对胸外科手术患者围手术期贫血管理的建议，阐述贫血对该患者群体预后的影响，并提出术前评估和治疗贫血的算法。
贫血是胸外科手术患者术前常见的医学问题，且具有显著的发病率。术前贫血增加了围手术期输血的可能性，这是胸外科手术肺癌患者发病和无病生存期缩短的重要危险因素。它还与更长的住院时间以及肺移植后再次手术的风险增加有关。基于算法的贫血管理方法是有益的，铁剂治疗已被证明可减少输血。
胸外科手术患者术前贫血发生率高，这增加了输血风险和术后发病率。基于贫血潜在病因的术前评估和针对性治疗可降低手术前贫血的发生率并降低输血率。
