Evaluation and Management of Perioperative Anemia

Ajay Kumar, MRCP, MD, FACP and Tomas Villanueva, DO, MBA, FACPE, SFHM

SUMMARY

Anemia is frequently seen in patients undergoing surgery, and patients with preoperative anemia are more likely to receive perioperative allogeneic blood transfusions than patients with normal hemoglobin levels. Allogeneic blood transfusions are associated with an increase in the rate of postoperative complications.

Evaluation of anemia should be performed in the preoperative period and begins with taking a detailed history and physical examination. All efforts must be used to correct anemia or reduce blood loss during surgery to avoid allogeneic blood transfusion. In this module, we will discuss many scenarios commonly faced in perioperative practice.

GOAL

To provide hospitalists with current information and guidelines for the treatment of perioperative anemia.

TARGET AUDIENCE

This activity is designed for hospitalists.

LEARNING OBJECTIVES

After completing the module, the participant should be able to:

  1. Identify the risks of anemia and blood transfusion in the perioperative period.
  2. Formulate an evaluation of anemia in the preoperative setting.
  3. Describe specific management strategies for several common causes of anemia.
  4. Assess appropriate perioperative transfusion thresholds.
  5. Summarize available modalities to reduce the risk of allogeneic blood exposure in the perioperative period.
  6. Formulate an evaluation of anemia in the postoperative setting.
CME INFORMATION

Accrediation Statement:

The Society of Hospital Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation Statement:

The Society of Hospital Medicine designates this activity for a maximum of 2 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Release date: January 8, 2018

Expiration date: November 22, 2020

Estimated time to complete activity: 2 hours

CONFLICT OF INTEREST DISCLOSURE POLICY

In accordance with the ACCME Standards for Commercial Support, SHM requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. SHM resolves all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs. All relevant financial relationships shall be disclosed to participants prior to the start of the activity.

Furthermore, SHM seeks to verify that all scientific research referred to, reported, or used in a continuing medical education (CME) activity conforms to the generally accepted standards of experimental design, data collection, and analysis. SHM is committed to providing its learners with high-quality CME activities that promote improvements in healthcare and not those of a commercial interest.

Course summary
Available credit: 
  • 2.00 AMA PRA Category 1 Credit™
  • 2.00 ABIM MOC Self Evaluation Points
    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 2.00 MOC points [and patient safety MOC credit] in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit
  • 2.00 Equivalent Credit
Course opens: 
01/08/2018
Course expires: 
11/22/2020
Non-member cost:
$0.00
Parent activity set: 
Rating: 
0

Leonard Feldman, MD, FACP, SFHM
Associate Professor of Medicine
Johns Hopkins University School of Medicine
Urban Health Residency and Track Director
Associate Program Director, Osler Medical Residency
Director, Comprehensive General Medicine Consult Service
Founding Editor-in-Chief, Consultative & Perioperative Medicine Essentials for Hospitalists
Baltimore, Maryland
Dr Feldman reports having no relevant financial or advisory relationships with corporate organizations related to this activity.

Kurt Pfeifer, MD, FACP, SFHM
Professor of Medicine
General Internal Medicine
Medical Director, Froedtert and Medical College of Wisconsin Eye Institute Perioperative Services
Medical College of Wisconsin
Associate Editor-in-Chief, Consultative & Perioperative Medicine Essentials for Hospitalists
Milwaukee, Wisconsin 
Dr. Pfeifer reports having no relevant financial or advisory relationships with corporate organizations related to this activity.

Ajay Kumar, MRCP, MD, FACP
Chief , Department of Medicine
Hartford Hospital
Hartford, Connecticut
Dr Kumar reports having no significant financial or advisory relationships with corporate organizations related to this activity.

Tomas Villanueva, DO, MBA, FACPE, SFHM
Medical Director, Hospital Medicine Program
Vice Chairman, Department of Medicine
Baptist Hospital of Miami
Miami, Florida
Dr Villanueva reports having no significant financial or advisory relationships with corporate organizations related to this activity.

Click here to download the references for this educational activity.

ACCREDITATION STATEMENT

The Society of Hospital Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
 

CREDIT DESIGNATION STATEMENT

The Society of Hospital Medicine designates this activity for a maximum of 2 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Available Credit

  • 2.00 AMA PRA Category 1 Credit™
  • 2.00 ABIM MOC Self Evaluation Points
    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 2.00 MOC points [and patient safety MOC credit] in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit
  • 2.00 Equivalent Credit

Accreditation Period

Course opens: 
01/08/2018
Course expires: 
11/22/2020

Price

Non-member cost:
$0.00
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The following is an interactive educational module designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of 3 sections: a pre-test, a study program, and a CME post-test. All 3 sections must be completed to receive CME credit.

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