Severe iron deficiency anemia: red blood cell transfusion or intravenous iron?

Nixon, Christian P.; Sweeney, Joseph D.

doi:10.1111/trf.14819

Cited by 2 publications

(2 citation statements)

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“…General unfamiliarity with these newer preparations, the historical concerns regarding anaphylactoid reactions and time delays are likely barriers to the widespread use of these agents in the treatment of IDA [20]. RBC transfusions carry the risk of haemolysis, transfusion‐associated circulatory overload (TACO), haemolysis and alloimmunization, and transfusion‐related acute lung injury (TRALI) should be considered a less safe alternative to oral and intravenous iron [17].…”

Section: Methodsmentioning

confidence: 99%

“…In IDA, the role of RBC transfusion is controversial. The Association for the Advancement of Blood and Biotherapies (AABB) and other organizations do recognize that RBC transfusion may be indicated if the patient has haemodynamic instability due to anaemia as this helps to alleviate severe morbidity associated with microvascular hypoxemia until the time iron therapy becomes clinically effective [17]. The treatment of pre‐operative IDA will improve haemoglobin before surgery, but good evidence exists that correcting anaemia by transfusing blood is detrimental to the outcomes of surgery, by increased risk for post‐operative complications [18].…”

Section: Methodsmentioning

confidence: 99%

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Patient blood management: Myths and facts about red blood cell transfusions

et al. 2023

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Transfusion medicine resembles all of medicine in that expert opinion predominates because hard data on clinical outcomes from randomized controlled trials and high quality observational data are simply unavailable. Indeed, some of the first trials evaluating important outcomes are barely two decades old. Patient blood management (PBM) depends on high quality data for assisting clinicians in making clinical decisions. In this review, we focus on several red blood cell (RBC) transfusion practices that new data suggest need reconsideration. The practices that may need revision include transfusion for iron deficiency anaemia, except in life threatening situations, toleration of anaemia as a largely benign condition and use of haemoglobin/haematocrit as primary indications for RBC transfusion, as opposed to adjuncts to clinical judgement. In addition, the long‐standing notion that the minimum transfusion should be two units needs to be abandoned due to the danger to patients and a lack of clinical evidence of benefit. Finally, the difference in indications for leucoreduction versus irradiation needs to be understood by all practitioners. PBM is one of the strategies for managing anaemia and bleeding that holds great promise for patients, and transfusion is only one facet of the bundle of practices.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%