Laboratory Markers of Impaired Erythropoiesis in Early Diagnosis of Perioperative Anemias.

The aim of the study was to assess the diagnostic value of laboratory indicators of hemoglobin content in reticulocytes for the early detection of predisposition for perioperative anemia in patients with total hemoglobin within the reference range.

Materials and methods: Observational retrospective single-center continuous cross-sectional study has been carried out to determine the need for transfusion of erythrocyte-containing components (ECC) depending on the values of reticulocyte hemoglobin (Ret-He) and delta-hemoglobin (Delta-He) in patients with unchanged (within the reference range) values of the total hemoglobin. The groups of comparison were formed using the diagnostic Hema-Plot algorithm, under which Ret-He and Delta-He values deviate from the reference range towards greater or smaller magnitudes in various types of anemia.

Results: Deviations from the reference intervals of Ret-He and Delta-He values were observed in 26% of patients not formally meeting the WHO criteria for anemia on admission. Indications for ECC transfusion therapy were more likely to occur in patients who had changes in Ret-He and Delta-He corresponding to the signs of anemias of different genesis according to the Hema-Plot algorithm.

Conclusion: The Ret-He and Delta-He values in patients with unchanged hemoglobin allow for making a decision on the need for ECC transfusion therapy in the postoperative period.The differences between the groups formed on the basis of Ret-He and Delta-He deviations from the reference values are in line with the diagnostic signs of anemias of various origins. They also allow one to discuss the variants of impaired erythropoiesis at the very early stages of the disorder and the risk of anemia development in patients with formally unchanged total hemoglobin levels.