Effects of intravenous iron combined with low‐dose recombinant human erythropoietin on transfusion requirements in iron‐deficient patients undergoing bilateral total knee replacement arthroplasty (CME)

Abstract

Treatment with parenteral iron and low-dose rHuEPO-β in bilateral TKRA effectively attenuated anemia and decreased transfusion requirements in iron-deficient patients.

Anaemia in the older surgical patient: a review of prevalence, causes, implications and management

“…68 A small study of intra-and postoperative intravenous iron and erythropoietin administration in patients undergoing elective bilateral total knee replacement also showed favourable results on reducing postoperative transfusions in the six weeks following surgery. 69 In elective colorectal 70 and gynaecological 71 surgical populations, contradictory results exist regarding the impact of intravenous iron in improving postoperative haemoglobin. The timing of iron administration in these studies differed (iron administered two weeks earlier in the hysterectomy study) which may account for the discrepancy in results with no benefit on postoperative haemoglobin seen in the colorectal group.…”

Assessment and treatment of preoperative anemia: Continuing Professional Development

“…10,49,[53][54][55][56] In these patient populations, ESAs have been shown to increase Hb levels, reduce allogeneic transfusion, increase aerobic capacity, and improve quality of life. 57 The ability of ESAs to reduce transfusions has been balanced by recent concerns of increased adverse outcomes (thrombosis, cancer progression) associated with ESA therapy in patients undergoing spine surgery and in patients with chronic renal failure and Sources: O'Brien et al 44 Vamvakas et al 43 RBC = red blood cells; HIV = human immunodeficiency virus; HCV = hepatitis C virus; HBV = hepatitis B virus; HTLV = Human T-cell leukemia/lymphoma virus; WNV = West Nile virus cancer.…”

“…10 In addition, clinical studies suggest that brief and/or low-dose treatment of anemic perioperative patients with ESAs may be a safe and effective means of increasing red cell mass and avoiding red cell transfusion. 48,49,55 Future studies are required to determine if aggressive treatment of anemia can improve patient outcomes following other types of surgery.…”

“…10,49,[53][54][55][56] Chez ces populations de patients, il a été démontré que les ESA augmentaient les taux de Hb, réduisaient les allotransfusions, augmentaient la capacité aérobique et amélioraient la qualité de vie. 57 La capacité des ESA à réduire les transfusions a été contrebalancée en raison d'inquiétudes récentes concernant une augmentation des pronostics défavorables (thrombose, progression du cancer) associés à un traitement à base d'ESA chez les patients subissant une chirurgie du rachis et chez les patients souffrant d'insuffisance rénale chronique et de cancer.…”

Patient blood management is a win-win: a wake-up call

“…21 22 This may be a useful concept in orthopaedic surgery. 23 For the reduction in perioperative blood loss, a bundle of measures needs to be combined ( Table 1). The most important is a meticulous surgical technique aiming at minimizing blood loss.…”