Case 136 – update 2

We are trying to optimise a 71 year old lady for orthopaedic surgery. You voted in the poll to proceed with IV iron – this has been administered at the correct weight-based dose for her Hb. Repeat bloods 6 weeks after iron infusion is shown below. The surgeons would like her Hb to be around 100 g/l:

Hb                   89 g/L

Ferritin            628 ug/l

Serum iron      5 umol/L

Transferrin      1,580 mg/L

Tsat                 16%

TIBC                 47 umol/L

Is there a role for EPO in this situation?

What peri-operative strategies would you advise the surgical team to consider?

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