Blood Management: Pumping Iron

To prepare for an upcoming hysterectomy, Anne Waters had five iron infusions and took a drug to stimulate red blood cell production — all in the hope of avoiding a blood transfusion later on.

Severely anemic due to the uterine fibroids she was diagnosed with several years ago, the 47-year-old Cleveland resident decided to participate in the Blood Management Program, launched by Cleveland Clinic in October 2009 to conserve available blood supplies and reduce rare transfusion-associated medical risks.

The ongoing pilot program encourages elective-surgery patients to keep close tabs on their hemoglobin counts, so if levels dip below the normal range (12 to 16 grams/deciliter), there is time to replenish iron reserves and minimize blood needs. Iron supplements, infusion and drugs, along with dietary changes, may be recommended.

Ms. Waters’ initial hemoglobin level was 8.6g/dL. After six weeks of customized treatment, her hemoglobin rose to 11.2g/dL, with a month left for additional improvement ahead of her scheduled surgery. She made it through surgery without the need for blood. On day two of her recovery she needed a transfusion for an accelerated heart rate. But all was fine.

“The whole point of the program is to get people to their best state of health prior to surgery,” so they do better in the operating room and recover faster, says Mick Benitez-Santana, Director of Blood Management. “It also leaves blood available for those who really need it in emergency situations.”

The program has served more than 100 patients, mostly for hysterectomies, hip replacements and colorectal operations. The intent is to expand the program to all Cleveland Clinic regional hospitals and beyond.

Read more information about blood management.