How I treat anemia in the perisurgical setting

Shander, Aryeh; Kaufman, Margit; Goodnough, Lawrence T.

doi:10.1182/blood.2019003945

Cited by 11 publications

(7 citation statements)

References 63 publications

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“…EPO-stimulating agents are administrated to patients at least five days before surgery, associated with intravenous iron injection. This treatment allows the application of pre-or perioperative auto-transfusion, dramatically reducing the risk of infectious agent transmission and alloimmunization [65].…”

Section: Erythropoietin (Epo)mentioning

confidence: 99%

Pro- and Anti-Inflammatory Prostaglandins and Cytokines in Humans: A Mini Review

Wautier

2023

IJMS

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Inflammation has been described for two millennia, but cellular aspects and the paradigm involving different mediators have been identified in the recent century. Two main groups of molecules, the prostaglandins (PG) and the cytokines, have been discovered and play a major role in inflammatory processes. The activation of prostaglandins PGE2, PGD2 and PGI2 results in prominent symptoms during cardiovascular and rheumatoid diseases. The balance between pro- and anti-inflammatory compounds is nowadays a challenge for more targeted therapeutic approaches. The first cytokine was described more than a century ago and is now a part of different families of cytokines (38 interleukins), including the IL-1 and IL-6 families and TNF and TGFβ families. Cytokines can perform a dual role, being growth promotors or inhibitors and having pro- and anti-inflammatory properties. The complex interactions between cytokines, vascular cells and immune cells are responsible for dramatic conditions and lead to the concept of cytokine storm observed during sepsis, multi-organ failure and, recently, in some cases of COVID-19 infection. Cytokines such as interferon and hematopoietic growth factor have been used as therapy. Alternatively, the inhibition of cytokine functions has been largely developed using anti-interleukin or anti-TNF monoclonal antibodies in the treatment of sepsis or chronic inflammation.

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Section: Erythropoietin (Epo)mentioning

confidence: 99%

Pro- and Anti-Inflammatory Prostaglandins and Cytokines in Humans: A Mini Review

Wautier

2023

IJMS

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“…Anemia during surgery is a typical clinical scenario. Anemia that develops postoperatively resembles chronic illness anemia and is likely due to the impact that inflammatory mediators generated both before and after surgery have on the growth and survival of RBCs [ 38 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

The incidence and factors associated with anemia in elective surgical patients admitted to a surgical intensive care unit: a retrospective cohort study

Wubet,

Mengistu,

Gobezie

et al. 2024

Eur J Med Res

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Background Anemia is a frequently reported and commonly documented issue in intensive care units. In surgical intensive care units, more than 90% of patients are found to be anemic. It is a hematologic factor that contributes to extended mechanical ventilation, sepsis, organ failure, longer hospitalizations in critical care units, and higher mortality. Thus, this study aimed to determine the incidence and identify factors associated with anemia in elective surgical patients admitted to the surgical intensive care unit. Methods A retrospective follow-up study involving 422 hospitalized patients was carried out between December 2019 and December 2022 in the surgical intensive care unit after elective surgery at Tikur-Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Data were gathered from the patients’ charts, and study participants were chosen using methods of systematic random sampling. SPSS 26 (the statistical software for social science, version 26) was used to analyze the data. Bivariable and multivariable binary logistic regression were used to examine associations between variables. Results The incidence of anemia in elective surgical patients admitted to the intensive care unit was 69.9% (95% CI 65.4–74.5%). American Society of Anesthesiologists’ class III (ASA III) [AOR: 8.53, 95% CI 1.92–13.8], renal failure [AOR:2.53, 95% CI (1.91–5.81)], malignancy [AOR: 2.59, 95% CI (1.31–5.09)], thoracic surgery [AOR: 4.07, 95% CI (2.11–7.87)], urologic surgery [AOR: 6.22, 95% CI (2.80–13.80)], and neurosurgery [AOR: 4.51, 95% CI (2.53–8.03)] were significantly associated with anemia in surgical patients admitted to the intensive care unit. Conclusion More than two-thirds of the intensive care unit-admitted surgical patients experienced anemia. An American Society of Anesthesiologists’ (ASA III score), renal failure, malignancy, thoracic surgery, urologic surgery, and neurosurgery were significantly associated with this condition. Early identification helps to institute preventive and therapeutic measures.

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“…Postoperative strategies include maximizing oxygen delivery, maintaining normothermia, minimizing iatrogenic blood loss, monitoring for adverse effects of medications, and avoiding/treating infections (Goodnough & Shander, 2012). It is essential to closely monitor the perioperative patient especially the individual who is at risk for postoperative bleeding and anemia (Shander et al, 2020). Management of anemia does not stop with the completion of surgery.…”

Section: Postoperative Managementmentioning

confidence: 99%

Blood Management for the Orthopaedic Surgical Patient

Smyke,

Sedlak

2023

Orthopaedic Nursing

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Prevention and management of anemia and blood loss in the orthopaedic patient undergoing surgery is a major concern for healthcare providers and patients. Although transfusion technology can be lifesaving, there are risks to blood products that have led to increased awareness of blood management and development of hospital patient blood management programs. Use of patient blood management can be effective in addressing preoperative anemia, a major modifiable risk factor in patients undergoing surgery. In this informational article, evidence-based practice guidelines for perioperative blood management are addressed. A case scenario is introduced focusing on a patient whose religious preference is Jehovah's Witness having “no blood wishes” undergoing elective orthopaedic surgery. Orthopaedic nurses can facilitate optimal patient blood management through multidisciplinary collaboration.

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How I treat anemia in the perisurgical setting

Cited by 11 publications

References 63 publications

Pro- and Anti-Inflammatory Prostaglandins and Cytokines in Humans: A Mini Review

Pro- and Anti-Inflammatory Prostaglandins and Cytokines in Humans: A Mini Review

The incidence and factors associated with anemia in elective surgical patients admitted to a surgical intensive care unit: a retrospective cohort study

Blood Management for the Orthopaedic Surgical Patient

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