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Iron deficiency with or without anemia and perspectives of perioperative management in children

Claudine Kumba

Background: Iron deficiency anemia (IDA) is the most common cause of anemia in children. Iron deficiency (ID) is the most common cause of nutrient deficiency in the pediatric population. ID has various etiologies including decreased iron intake and absorption, increased iron requirement and loss. ID and IDA have been associated with adverse neurodevelopmental outcome in children. Anemia in children has been related with increased mortality. The prevalence of ID and IDA in children in the general population is 6.6% to 15.2% and 0.9% to 4.4% respectively in the USA according to one study. IDA and ID treatment includes iron supplementation and correction of anemia with this therapy can take several weeks. Anticipating treatment of iron deficiency anemia due to blood loss in the perioperative period seems intuitively an important issue to reduce blood transfusion in this setting. Since the latter has been shown to be predictive of adverse postoperative outcome in children. Evidence concerning reduction of blood transfusion requirements perioperatively when IDA and ID were diagnosed, prevented and treated preoperatively is lacking in the pediatric population.

Objective: This narrative review was undertaken to determine the impact of preoperative management of ID and IDA on perioperative blood transfusion in children.

Methods: Narrative review of the litterature.

Conclusion and Results: There are no randomized controlled studies concerning the impact of preoperative management of ID and IDA on perioperative blood transfusion in children. There is evidence that ID and IDA diagnosis, prevention and treatment in the general pediatric population increase hemoglobin levels.