Abstract
Polycythemia indicates an absolute increase in total red blood cell mass. Polycythemia has primary, secondary and mixed types. Polycythemia Vera (PV), a clonal disorder of hematopoietic stem/progenitor cells, is the most common form of primary polycythemias. PV is a neoplasm with gene mutations leading to overproduction of morphologically and functionally normal blood cells. The perioperative complications of polycythemia include thromboembolic events leading to stroke, acute myocardial infarction, and peripheral vascular occlusions. Patients with PV may also suffer from hemorrhagic complications. Patients with PV with low cardiovascular risk can be treated with aspirin and phlebotomy with a target hematocrit <45%, but high-risk patients will necessitate cytoreductive therapy usually with hydroxyurea. Some patients who cannot tolerate or resistant to hydroxyurea will need interferon or Ruxolitinib. Based on current guidelines for the management of PV, most patients can have long and productive lives. The anesthetic considerations for patients with PV should include control hematocrit level to <45% preoperatively, appropriate hemodilution intraoperatively, and closely monitoring hematocrit level and occurrence of potential complications postoperatively.
Original language | English (US) |
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Title of host publication | Essentials of Blood Product Management in Anesthesia Practice |
Publisher | Springer International Publishing |
Pages | 405-409 |
Number of pages | 5 |
ISBN (Electronic) | 9783030592950 |
ISBN (Print) | 9783030592943 |
DOIs | |
State | Published - May 19 2021 |
All Science Journal Classification (ASJC) codes
- General Medicine