Perioperative anemia management in colorectal cancer patients: A pragmatic approach
| Autor: | Elisa Martín-Montañez, Susana Gómez-Ramírez, Manuel Muñoz, Michael Auerbach |
|---|---|
| Přispěvatelé: | [Muñoz, M] Transfusion Medicine, School of Medicine, University of Málaga, Málaga, Spain. [Gómez-Ramírez, S] Internal Medicine, University Hospital Virgen de la Victoria, Málaga, Spain. [Martín-Montañez, E] Department of Pharmacology, School of Medicine, University of Málaga, Málaga, Spain. [Auerbach, M] Georgetown University School of Medicine, Washington, DC, United States. |
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Blood management Blood transfusion Anemia Colorectal cancer medicine.medical_treatment Iron Erythropoiesis stimulating agents Diseases::Bacterial Infections and Mycoses::Infection::Cross Infection [Medical Subject Headings] Perioperative Care Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings] Allogeneic blood transfusion Intravenous iron Infección hospitalaria Neoplasias colorrectales Patient blood management Medicine Humans Analytical Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Biological Therapy::Blood Transfusion [Medical Subject Headings] Blood Transfusion Topic Highlight Intensive care medicine Adverse effect Perioperative Period Erythropoietin Transfusión sanguínea business.industry Gastroenterology Diseases::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms [Medical Subject Headings] General Medicine Perioperative Iron deficiency medicine.disease Europe Oxygen Quality of Life Female business Colorectal Neoplasms Diseases::Hemic and Lymphatic Diseases::Hematologic Diseases::Anemia [Medical Subject Headings] Diseases::Cardiovascular Diseases::Vascular Diseases::Embolism and Thrombosis::Thromboembolism::Venous Thromboembolism [Medical Subject Headings] Algorithms Tromboembolia venosa medicine.drug |
| Popis: | REVIEW; Anemia, usually due to iron deficiency, is highly prevalent among patients with colorectal cancer. Inflammatory cytokines lead to iron restricted erythropoiesis further decreasing iron availability and impairing iron utilization. Preoperative anemia predicts for decreased survival. Allogeneic blood transfusion is widely used to correct anemia and is associated with poorer surgical outcomes, increased post-operative nosocomial infections, longer hospital stays, increased rates of cancer recurrence and perioperative venous thromboembolism. Infections are more likely to occur in those with low preoperative serum ferritin level compared to those with normal levels. A multidisciplinary, multimodal, individualized strategy, collectively termed Patient Blood Management, minimizes or eliminates allogeneic blood transfusion. This includes restrictive transfusion policy, thromboprophylaxis and anemia management to improve outcomes. Normalization of preoperative hemoglobin levels is a World Health Organization recommendation. Iron repletion should be routinely ordered when indicated. Oral iron is poorly tolerated with low adherence based on published evidence. Intravenous iron is safe and effective but is frequently avoided due to misinformation and misinterpretation concerning the incidence and clinical nature of minor infusion reactions. Serious adverse events with intravenous iron are extremely rare. Newer formulations allow complete replacement dosing in 15-60 min markedly facilitating care. Erythropoiesis stimulating agents may improve response rates. A multidisciplinary, multimodal, individualized strategy, collectively termed Patient Blood Management used to minimize or eliminate allogeneic blood transfusion is indicated to improve outcomes. Yes |
| Databáze: | OpenAIRE |
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