Table of ContentsView AllTable of ContentsSymptomsComplicationsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms
Complications
Causes
Diagnosis
Treatment
Anemiais a condition in which your body does not have enoughred blood cells (RBC)to carry oxygen to all your cells. Postoperative anemia refers to a drop in red blood cells that occurs as a result of blood loss during surgery. It is a common risk of surgery that can result in a longer recovery and increase the risk of complications.
If you have anemia, you might feel weak, short of breath, or lightheaded. Some people with anemia have headaches, pale skin, or cold hands and feet.In most cases, postoperative anemia is temporary. More severe cases of postoperative anemia may need to be treated with ablood transfusion, in which donated blood is administered through an IV.
This article explains what postoperative anemia is, the symptoms it may cause, and why exactly it happens due to surgery. It also discusses how postoperative anemia is diagnosed and treated.
What Are the Different Types of Anemia?
Verywell / Theresa Chiechi
What Are the Symptoms of Postoperative Anemia?
Anemia signs and symptomscan range from mild to severe. Postoperative anemia is common, affecting around 90% of people following surgery.Fortunately, it tends to be transient (short-lived) and does not usually require a transfusion.
Postoperative anemia symptoms may include:
If anemia is present before surgery (preoperative anemia), determining the cause and correcting the problem is essential, especially if the anemia is severe.
Signs and Symptoms of Internal Bleeding
What Happens if Your Hemoglobin is Low After Surgery?
Postoperative anemia increases the risk of complications during the recovery period. People with postoperative anemia are more likely to experience:
Furthermore, those who require a blood transfusion due to postoperative anemia have an increased risk of:
Additionally, having postoperative anemia or a blood transfusion increases the risk of death within the first 30 days after surgery.
Causes and Risk Factors of Postoperative Anemia
Anemia develops when an individual makes too few red blood cells or loses an abnormally high number of red blood cells through bleeding. Bleeding is common during and after surgery and can range from mild to life-threatening.
Higher Risk
Some health conditions, injuries, and types of surgery increase the risk of bleeding and thus postoperative anemia, including:
Lowering Risk
Minimally invasive surgery involving smaller incisions causes less blood loss than open surgery. Therefore, surgeons commonly advise people with bleeding disorders to undergolaparoscopy, also called “keyhole surgery,” rather than an open surgery if at all possible.
During laparoscopic procedures, surgeons thread cameras through small incisions that allow them to see what they are working on. Due to the smaller incision size, this often results in less blood loss.
Today, surgeons can perform an increasing number of surgeries laparoscopically. Less invasive surgical incisions reduce the risk of complications and shorten recovery times.
How is Postoperative Anemia Diagnosed?
A CBC, which includes ahemoglobin test, is the primary test used to evaluate anemia before and after surgery. Each test in the CBC has a reference range of values—including an upper and lower value—between which the count is considered “normal.” RBC and hemoglobin values below the reference range indicate anemia.
Symptoms of severe anemia can include:
Because postoperative anemia tends to be short-lived in healthy individuals, a transfusion is not indicated until the hemoglobin is below 7 gm/dL or 8 gm/dL in people with heart conditions.
What Hemoglobin is Too Low for Surgery?
In adults, a hemoglobin level below 13 gm/dL is considered preoperative anemia. Having preoperative anemia increases the risk of surgical complications, as well as the need for a blood transfusion after surgery.A discovery of anemia in routine preoperative blood tests will prompt treatment to correct hemoglobin levels well before surgery.
How is Postoperative Anemia Treated?
Anemia treatment varies depending on the underlying cause. For example, if an individual hasiron deficiency anemia, aniron supplementis typically the best option. However, if anemia occurs due to blood loss from surgery, treatment may require a different approach.
Transfusion
A blood transfusion is the most immediate and effective treatment for someone with significant blood loss from surgery or trauma.
Therisks associated with blood transfusionsare low. In rare instances, an allergic reaction may occur. Due to the routine screening of the blood supply in the United States, the risk of infections (such asviral hepatitisandHIV) is extremely low.
According to the American Red Cross, the risk of HIV,hepatitis C, andhepatitis Bfrom a blood transfusion is one per 2.3 million, 2.6 million, and 1.5 million donations, respectively.
Watchful Waiting
The treatment is usually watchful waiting for those who experience mild anemia after surgery. Over the weeks following surgery, your body will rebuild your blood supply.
Fatigue and low energy levels usually improve over time. Depending on your surgery and postoperative care, you will likely be back to your normal levels within a week or two.
How Long Will Recovery Take After Surgery?
Iron Supplements
Iron supplementsare commonly prescribed to people with anemia. The body uses iron to make hemoglobin and myoglobin, two proteins that are essential for circulating oxygen through the body.
Iron supplements come in several forms, including ferrous iron salts, ferric iron salts, ferric citrate, and ferric sulfate. Among them, ferrous iron has the highest bioavailability, meaning that it is easiest for your body to digest, absorb, and make use of.
Summary
Postoperative anemia sometimes occurs following surgery as a result of blood loss. Open surgery, trauma surgery, and having a bleeding disorder increase your risk of postoperative anemia. Less invasive techniques, such as laparoscopic surgery, lower the risk. Treatment for postoperative anemia sometimes requires a blood transfusion, but often watchful waiting is appropriate.
If you’re worried that you could need a blood transfusion after surgery, talk to your surgeon aboutautologousblood donation. In this procedure, your blood is taken before surgery and used after surgery if needed. This process eliminates any risk of disease transmission.
Donating Your Own Blood Before Surgery
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Giribabu P, Karan N, Sriganesh K, Shukla D, Devi B.Incidence, risk factors and impact of anemia after elective neurosurgery: A retrospective cohort study.World Neurosurg X. 2024 Apr;22(1):100289. doi:10.1016/j.wnsx.2024.100289Weckmann G, Kiel S, Chenot JF, Angelow A.Association of anemia with clinical symptoms commonly attributed to anemia—analysis of two population-based cohorts.J Clin Med. 2023 Feb;12(3):921. doi:10.3390/jcm12030921Muñoz M, Franchini M, Liumbruno GM.The post-operative management of anaemia: more efforts are needed.Blood Transfus. 2018 Jul;16(4): 324-5. doi:10.2450/2018.0036-18D’John J, Hutchins M, Januchowski R.Medical management of anemia in the surgical patient.Osteopath Fam Phys. 2016;8(5):28-31.Crispell E, Trinh J, Warner M.Postoperative anaemia: Hiding in plain sight.Best Pract & Res Clin Anaest. 2023 Dec;37(4):486-494. doi:10.1016/j.bpa.2023.11.002Kunz J, Spies C, Bichmann A, Sieg M, Mueller A.Postoperative anaemia might be a risk factor for postoperative delirium and prolonged hospital stay: A secondary analysis of a prospective cohort study.PLoS One. 2020 Feb;15(2):e0229325. doi:10.1371/journal.pone.0229325Lingohr P, Bensoukehal S, Matthaei H, et al.Value and risk of laparoscopic surgery in hemophiliacs-experiences from a tertiary referral center for hemorrhagic diatheses.Langenbecks Arch Surg. 2014;399(5):609-18. doi:10.1007/s00423-014-1185-7Penn State.What is anemia?.Lin Y.Preoperative anemia-screening clinics.Am Soc Hematol Educ Program. 2019;1(1):570-576. doi:10.1182/hematology.2019000061National Heart, Lung, and Blood Institute.Blood transfusion.Dodd RY, Crowder LA, Haynes JM, Notari EP, Stramer SL and WR Steele.Screening of blood donors for HIV, HCV and HBV at the American Red Cross: ten-year trends in prevalence, incidence and residual risk, 2007-2016.Transfusion Med Rev. 2020 Apr;34(2):81-93. doi:10.1016/j.tmrv.2020.02.001National Institutes of Health.Iron.
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Giribabu P, Karan N, Sriganesh K, Shukla D, Devi B.Incidence, risk factors and impact of anemia after elective neurosurgery: A retrospective cohort study.World Neurosurg X. 2024 Apr;22(1):100289. doi:10.1016/j.wnsx.2024.100289Weckmann G, Kiel S, Chenot JF, Angelow A.Association of anemia with clinical symptoms commonly attributed to anemia—analysis of two population-based cohorts.J Clin Med. 2023 Feb;12(3):921. doi:10.3390/jcm12030921Muñoz M, Franchini M, Liumbruno GM.The post-operative management of anaemia: more efforts are needed.Blood Transfus. 2018 Jul;16(4): 324-5. doi:10.2450/2018.0036-18D’John J, Hutchins M, Januchowski R.Medical management of anemia in the surgical patient.Osteopath Fam Phys. 2016;8(5):28-31.Crispell E, Trinh J, Warner M.Postoperative anaemia: Hiding in plain sight.Best Pract & Res Clin Anaest. 2023 Dec;37(4):486-494. doi:10.1016/j.bpa.2023.11.002Kunz J, Spies C, Bichmann A, Sieg M, Mueller A.Postoperative anaemia might be a risk factor for postoperative delirium and prolonged hospital stay: A secondary analysis of a prospective cohort study.PLoS One. 2020 Feb;15(2):e0229325. doi:10.1371/journal.pone.0229325Lingohr P, Bensoukehal S, Matthaei H, et al.Value and risk of laparoscopic surgery in hemophiliacs-experiences from a tertiary referral center for hemorrhagic diatheses.Langenbecks Arch Surg. 2014;399(5):609-18. doi:10.1007/s00423-014-1185-7Penn State.What is anemia?.Lin Y.Preoperative anemia-screening clinics.Am Soc Hematol Educ Program. 2019;1(1):570-576. doi:10.1182/hematology.2019000061National Heart, Lung, and Blood Institute.Blood transfusion.Dodd RY, Crowder LA, Haynes JM, Notari EP, Stramer SL and WR Steele.Screening of blood donors for HIV, HCV and HBV at the American Red Cross: ten-year trends in prevalence, incidence and residual risk, 2007-2016.Transfusion Med Rev. 2020 Apr;34(2):81-93. doi:10.1016/j.tmrv.2020.02.001National Institutes of Health.Iron.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Giribabu P, Karan N, Sriganesh K, Shukla D, Devi B.Incidence, risk factors and impact of anemia after elective neurosurgery: A retrospective cohort study.World Neurosurg X. 2024 Apr;22(1):100289. doi:10.1016/j.wnsx.2024.100289Weckmann G, Kiel S, Chenot JF, Angelow A.Association of anemia with clinical symptoms commonly attributed to anemia—analysis of two population-based cohorts.J Clin Med. 2023 Feb;12(3):921. doi:10.3390/jcm12030921Muñoz M, Franchini M, Liumbruno GM.The post-operative management of anaemia: more efforts are needed.Blood Transfus. 2018 Jul;16(4): 324-5. doi:10.2450/2018.0036-18D’John J, Hutchins M, Januchowski R.Medical management of anemia in the surgical patient.Osteopath Fam Phys. 2016;8(5):28-31.Crispell E, Trinh J, Warner M.Postoperative anaemia: Hiding in plain sight.Best Pract & Res Clin Anaest. 2023 Dec;37(4):486-494. doi:10.1016/j.bpa.2023.11.002Kunz J, Spies C, Bichmann A, Sieg M, Mueller A.Postoperative anaemia might be a risk factor for postoperative delirium and prolonged hospital stay: A secondary analysis of a prospective cohort study.PLoS One. 2020 Feb;15(2):e0229325. doi:10.1371/journal.pone.0229325Lingohr P, Bensoukehal S, Matthaei H, et al.Value and risk of laparoscopic surgery in hemophiliacs-experiences from a tertiary referral center for hemorrhagic diatheses.Langenbecks Arch Surg. 2014;399(5):609-18. doi:10.1007/s00423-014-1185-7Penn State.What is anemia?.Lin Y.Preoperative anemia-screening clinics.Am Soc Hematol Educ Program. 2019;1(1):570-576. doi:10.1182/hematology.2019000061National Heart, Lung, and Blood Institute.Blood transfusion.Dodd RY, Crowder LA, Haynes JM, Notari EP, Stramer SL and WR Steele.Screening of blood donors for HIV, HCV and HBV at the American Red Cross: ten-year trends in prevalence, incidence and residual risk, 2007-2016.Transfusion Med Rev. 2020 Apr;34(2):81-93. doi:10.1016/j.tmrv.2020.02.001National Institutes of Health.Iron.
Giribabu P, Karan N, Sriganesh K, Shukla D, Devi B.Incidence, risk factors and impact of anemia after elective neurosurgery: A retrospective cohort study.World Neurosurg X. 2024 Apr;22(1):100289. doi:10.1016/j.wnsx.2024.100289
Weckmann G, Kiel S, Chenot JF, Angelow A.Association of anemia with clinical symptoms commonly attributed to anemia—analysis of two population-based cohorts.J Clin Med. 2023 Feb;12(3):921. doi:10.3390/jcm12030921
Muñoz M, Franchini M, Liumbruno GM.The post-operative management of anaemia: more efforts are needed.Blood Transfus. 2018 Jul;16(4): 324-5. doi:10.2450/2018.0036-18
D’John J, Hutchins M, Januchowski R.Medical management of anemia in the surgical patient.Osteopath Fam Phys. 2016;8(5):28-31.
Crispell E, Trinh J, Warner M.Postoperative anaemia: Hiding in plain sight.Best Pract & Res Clin Anaest. 2023 Dec;37(4):486-494. doi:10.1016/j.bpa.2023.11.002
Kunz J, Spies C, Bichmann A, Sieg M, Mueller A.Postoperative anaemia might be a risk factor for postoperative delirium and prolonged hospital stay: A secondary analysis of a prospective cohort study.PLoS One. 2020 Feb;15(2):e0229325. doi:10.1371/journal.pone.0229325
Lingohr P, Bensoukehal S, Matthaei H, et al.Value and risk of laparoscopic surgery in hemophiliacs-experiences from a tertiary referral center for hemorrhagic diatheses.Langenbecks Arch Surg. 2014;399(5):609-18. doi:10.1007/s00423-014-1185-7
Penn State.What is anemia?.
Lin Y.Preoperative anemia-screening clinics.Am Soc Hematol Educ Program. 2019;1(1):570-576. doi:10.1182/hematology.2019000061
National Heart, Lung, and Blood Institute.Blood transfusion.
Dodd RY, Crowder LA, Haynes JM, Notari EP, Stramer SL and WR Steele.Screening of blood donors for HIV, HCV and HBV at the American Red Cross: ten-year trends in prevalence, incidence and residual risk, 2007-2016.Transfusion Med Rev. 2020 Apr;34(2):81-93. doi:10.1016/j.tmrv.2020.02.001
National Institutes of Health.Iron.
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