When anemia is identified before surgery, it may be possible to provide oral or IV iron to patients to increase hemoglobin. Most patients will see their surgeon within 30 days of the scheduled surgery.
Both methods of iron administration have their drawbacks. Due to constipation, many patients will not take oral iron as instructed. Facilities may not have outpatient infusion space for iron infusions and the patient needs to come to the clinic for the infusion. Thus, programmatic changes may be needed to implement this method of reducing transfusions. It also requires a standardized process for rescheduling elective surgeries when the patient is found to be anemic allowing the patient time to recover from their anemia.
Agents that stimulate red cell erythropoiesis may also be used in some circumstances. However, this may lead to iron deficiency necessitating therapy with intravenous Iron.