Patient Blood Management: An Internist's Perspective / 한양의대학술지
Hanyang Medical Reviews
;
: 38-48, 2018.
Artigo
em Inglês
| WPRIM
| ID: wpr-713732
ABSTRACT
Patient blood management (PBM) is an evidence-based, patient-focused approach to optimize the management of patient and blood transfusion. While PBM is relatively well established in perioperative care, it is not as well established in the medical field. Since anemia in medical patients is heterogeneous and complex in its pathogenesis, the evidence for the threshold of hemoglobin for red blood cell (RBC) transfusion and the use of erythropoiesis-stimulating agents (ESAs) is not strong. While anemia seems to be an adverse risk factor for mortality, it is uncertain if rapid correction of anemia through RBC transfusion can reverse the negative impact of anemia on clinical outcomes. The introduction of ESA is a breakthrough in reducing RBC transfusion and managing anemic patients with renal disease and cancer. Despite promising results from early trials, the United States Food and Drug Administration issued a black box warning for ESAs in 2007 because of concerns about higher mortality, serious cardiovascular and thromboembolic events, and tumor progression. Therefore, the individualized approach to each patient with anemia is recommended in various medical conditions such as acute coronary syndrome, heart failure, chronic kidney disease, and malignancies.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
United States Food and Drug Administration
/
Transfusão de Sangue
/
Fatores de Risco
/
Mortalidade
/
Eritropoetina
/
Assistência Perioperatória
/
Rotulagem de Medicamentos
/
Eritrócitos
/
Insuficiência Renal Crônica
/
Síndrome Coronariana Aguda
Tipo de estudo:
Estudo de etiologia
/
Estudo prognóstico
/
Fatores de risco
Limite:
Humanos
Idioma:
Inglês
Revista:
Hanyang Medical Reviews
Ano de publicação:
2018
Tipo de documento:
Artigo
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