Blood transfusion and lung function in chronically anemic patients with severe chronic obstructive pulmonary disease

Schönhofer, Bernd; Wenzel, M; Geibel, M; Köhler, Dieter

doi:10.1097/00003246-199811000-00022

Cited by 122 publications

(100 citation statements)

References 16 publications

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“…The observation of SCHONHÖ FER et al [45], that RBC transfusion in COPD patients does reduce V9E (see above), thus allows the speculation that a reduction in the degree of dynamic hyperinflation could be expected in response to an increase in the haemoglobin level. This would be very similar to the effects of oxygen administration prior to exercise in severe COPD patients [47,48].…”

Section: Breathing Patternmentioning

confidence: 88%

“…In one of the studies, blood cell transfusion in anaemic COPD patients was shown to lead to a significant reduction in both minute ventilation (V9E) and work of breathing (WOB) [45]. In the study, 10 patients with COPD (mean FEV1 0.55 L) were compared with 10 patients without lung disease before and after receiving RBC transfusion.…”

Section: Symptoms and Morbiditymentioning

confidence: 99%

“…Pathophysiological basis for the benefit of raising haemoglobin in COPD Whether raising haemoglobin levels in COPD would decrease mortality remains to be studied and, as with heart failure, it is [45] with permission from the publisher.…”

Section: Symptoms and Morbiditymentioning

confidence: 99%

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The potential impact of anaemia of chronic disease in COPD

Similowski

Agustí²,

MacNee³

et al. 2006

European Respiratory Journal

148

107

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Anaemia of chronic disease (ACD), with chronically low levels of circulating haemoglobin, is an immune driven abnormality that occurs in many inflammatory diseases, and also in chronic heart failure. Although chronic obstructive pulmonary disease (COPD) is ''traditionally'' associated with polycythaemia, the systemic inflammation that is now recognised as a feature of COPD makes it a possible cause of ACD. If present in COPD, anaemia could worsen dyspnoea and limit exercise tolerance.Preliminary evidence suggests that anaemia in COPD patients may be more prevalent than expected, concerning 10-15% of patients suffering from severe forms of the disease. A database study conducted in 2,524 COPD patients being prescribed long-term oxygen therapy has shown that a low haematocrit is a strong predictor of survival in this population, before body mass index, and is associated with more hospitalisations and a longer cumulative duration of hospitalisation. COPD patients with low haemoglobin levels have a poorer prognosis than COPD patients with normal haemoglobin levels in the event of acute gastrointestinal bleeding or after elective aneurysm repair. Raising haemoglobinaemia through transfusion decreases minute ventilation and work of breathing in COPD patients.These preliminary evidences point to the need to study the prevalence of anaemia, and its physiological and clinical impact in chronic obstructive pulmonary disease. When this body of knowledge is available, the question of the putative benefits of raising haemoglobinaemia in chronic obstructive pulmonary disease will have to be addressed.

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Section: Breathing Patternmentioning

confidence: 88%

Section: Symptoms and Morbiditymentioning

confidence: 99%

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The potential impact of anaemia of chronic disease in COPD

Similowski

Agustí²,

MacNee³

et al. 2006

European Respiratory Journal

148

107

View full text Add to dashboard Cite

show abstract

“…Treatment with erythropoietin is unlikely to be useful as there is end-organ resistance, indicating that blood transfusion may be necessary. In a small study in anaemic COPD patients, blood transfusion improved their exercise performance [120]. Iron supplements are likely to be detrimental as iron cannot be utilised correctly and may increase systemic oxidative stress.…”

Section: Arterial Stiffness and Endothelial Functionmentioning

confidence: 97%

Systemic manifestations and comorbidities of COPD

Barnes¹,

Celli²

2009

European Respiratory Journal

1,444

1,113

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Increasing evidence indicates that chronic obstructive pulmonary disease (COPD) is a complex disease involving more than airflow obstruction. Airflow obstruction has profound effects on cardiac function and gas exchange with systemic consequences. In addition, as COPD results from inflammation and/or alterations in repair mechanisms, the ''spill-over'' of inflammatory mediators into the circulation may result in important systemic manifestations of the disease, such as skeletal muscle wasting and cachexia. Systemic inflammation may also initiate or worsen comorbid diseases, such as ischaemic heart disease, heart failure, osteoporosis, normocytic anaemia, lung cancer, depression and diabetes. Comorbid diseases potentiate the morbidity of COPD, leading to increased hospitalisations, mortality and healthcare costs. Comorbidities complicate the management of COPD and need to be evaluated carefully. Current therapies for comorbid diseases, such as statins and peroxisome proliferator-activated receptor-agonists, may provide unexpected benefits for COPD patients. Treatment of COPD inflammation may concomitantly treat systemic inflammation and associated comorbidities. However, new broad-spectrum anti-inflammatory treatments, such as phosphodiesterase 4 inhibitors, have significant side-effects so it may be necessary to develop inhaled drugs in the future. Another approach is the reversal of corticosteroid resistance, for example with effective antioxidants. More research is needed on COPD comorbidities and their treatment.

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“…In 10 anemic patients with stable severe COPD, Schö nhofer and colleagues found that transfusion to a goal hemoglobin greater than 11 g/dl decreased ventilation and work of breathing (33). In a study of five anemic patients with COPD (mean hemoglobin, 8.7 g/dl) who were unable to be liberated from mechanical ventilation (28-d mean duration of ventilation; range, 13 to 49 d) (86), all were successfully extubated within 4 days of being transfused to a mean hemoglobin level of 12.4 g/dl.…”

Section: Management Of Anemia In Critical Illness Blood Transfusionsmentioning

confidence: 99%

Anemia in Critical Illness

Hayden

Albert

Watkins

et al. 2012

Am J Respir Crit Care Med

199

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Anemia is common in the intensive care unit, and may be associated with adverse consequences. However, current options for correcting anemia are not without problems and presently lack convincing efficacy for improving survival in critically ill patients. In this article we review normal red blood cell physiology; etiologies of anemia in the intensive care unit; its association with adverse outcomes; and the risks, benefits, and efficacy of various management strategies, including blood transfusion, erythropoietin, blood substitutes, iron therapy, and minimization of diagnostic phlebotomy.

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Blood transfusion and lung function in chronically anemic patients with severe chronic obstructive pulmonary disease

Abstract: We conclude that red blood cell transfusion in anemic patients with COPD leads to a significant reduction of both the minute ventilation and the WOB. In these patients, transfusion may be associated with unloading of the respiratory muscles, but it may also result in mild hypoventilation.

Cited by 122 publications

References 16 publications

The potential impact of anaemia of chronic disease in COPD

The potential impact of anaemia of chronic disease in COPD

Systemic manifestations and comorbidities of COPD

Anemia in Critical Illness

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