Diagnosis and Management of Anemia

Dear Colleagues,

Anemia and iron deficiency are frequent findings in the preoperative and postoperative period of major surgery and in critical care units. Not only are they related to a higher risk of transfusion and its adverse effects, but they are also an independent factor of higher morbidity and mortality.

Its correction constitutes the first pillar of patient blood management, to improve clinical safety, and is a recommendation both from the WHO and numerous scientific and right-care societies.

The problem is that in striving to achieve an adequate management in this context of little time for optimization and a large proportion of patients with chronic or acute inflammation, it is a challenge to distinguish between iron-deficiency anemia, functional iron deficiency, or anemia of chronic process.

In these last years, much progress has been made in the knowledge of iron metabolism and the pathophysiology of iron-deficiency or inflammatory anemia. Likewise, we have new parameters that may be helpful for an adequate diagnosis in this context, such as the hypochromia biomarkers available in the new hematology analyzers, and the usefulness of hepcidin levels is even being studied to guide whether the patient requires intravenous iron, erythropoietin, or both.

Dr. Elvira Bisbe
Guest Editor

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• anemia
• iron deficiency
• functional iron deficiency
• anemia of chronic disease
• biomarkers of hypochromia
• hepcidin
• patient blood management
• perioperative medicine
• inflammation
• iron metabolism