Management of postoperative anemia in adults

pRBCs: packed red blood cells; CBC: complete blood count; PT: prothrombin time; aPTT: activated partial thromboplastin time.
* RBC transfusion is the fastest way to raise the hemoglobin but should only be used when necessary. Severe anemia generally refers to a hemoglobin level of <7 to 8 g/dL or anemia with symptoms of hemodynamic compromise or cardiac ischemia. Transfusions may reasonably be omitted in individuals who are asymptomatic with a hemoglobin in this range, especially if they are young and without cardiovascular disease. One unit of pRBCs is unlikely to completely replete body iron stores if iron deficiency is present.
¶ Initial testing for a suspected bleeding disorder includes coagulation tests (PT and aPTT) and platelet count. Additional testing such as fibrinogen and D-dimer may be ordered simultaneously if there are signs of significant coagulopathy, or subsequently after a finding of an abnormal PT and/or aPTT. Refer to UpToDate for interpretation of the results of testing and a general approach to bleeding disorders.
Δ At a minimum, the evaluation for anemia should include review of the CBC and RBC indices and iron studies. Other evaluations are guided by the clinical scenario, as discussed in UpToDate.