Please use this identifier to cite or link to this item:
Title: Perioperative anemia management in colorectal cancer patients: A pragmatic approach.
Authors: Muñoz, Manuel
Gómez-Ramírez, Susana
Martín-Montañez, Elisa
Auerbach, Michael
metadata.dc.contributor.authoraffiliation: [Muñoz, M] Transfusion Medicine, School of Medicine, University of Málaga, Málaga, Spain. [Gómez-Ramírez, S] Internal Medicine, University Hospital Virgen de la Victoria, Málaga, Spain. [Martín-Montañez, E] Department of Pharmacology, School of Medicine, University of Málaga, Málaga, Spain. [Auerbach, M] Georgetown University School of Medicine, Washington, DC, United States.
Keywords: Colorectal cancer;Anemia;Allogeneic blood transfusion;Intravenous iron;Erythropoiesis stimulating agents;Patient blood management;Neoplasias colorrectales;Infección hospitalaria;Transfusión sanguínea;Tromboembolia venosa
metadata.dc.subject.mesh: Medical Subject Headings::Diseases::Hemic and Lymphatic Diseases::Hematologic Diseases::Anemia
Medical Subject Headings::Diseases::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Infection::Cross Infection
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Biological Therapy::Blood Transfusion
Medical Subject Headings::Diseases::Cardiovascular Diseases::Vascular Diseases::Embolism and Thrombosis::Thromboembolism::Venous Thromboembolism
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Issue Date: 28-Feb-2014
Publisher: Baishideng Publishing Group Co. Limited
Citation: Muñoz M, Gómez-Ramírez S, Martín-Montañez E, Auerbach M. Perioperative anemia management in colorectal cancer patients: A pragmatic approach. World J. Gastroenterol. 2014; 20(8):1972-1985
Abstract: Anemia, usually due to iron deficiency, is highly prevalent among patients with colorectal cancer. Inflammatory cytokines lead to iron restricted erythropoiesis further decreasing iron availability and impairing iron utilization. Preoperative anemia predicts for decreased survival. Allogeneic blood transfusion is widely used to correct anemia and is associated with poorer surgical outcomes, increased post-operative nosocomial infections, longer hospital stays, increased rates of cancer recurrence and perioperative venous thromboembolism. Infections are more likely to occur in those with low preoperative serum ferritin level compared to those with normal levels. A multidisciplinary, multimodal, individualized strategy, collectively termed Patient Blood Management, minimizes or eliminates allogeneic blood transfusion. This includes restrictive transfusion policy, thromboprophylaxis and anemia management to improve outcomes. Normalization of preoperative hemoglobin levels is a World Health Organization recommendation. Iron repletion should be routinely ordered when indicated. Oral iron is poorly tolerated with low adherence based on published evidence. Intravenous iron is safe and effective but is frequently avoided due to misinformation and misinterpretation concerning the incidence and clinical nature of minor infusion reactions. Serious adverse events with intravenous iron are extremely rare. Newer formulations allow complete replacement dosing in 15-60 min markedly facilitating care. Erythropoiesis stimulating agents may improve response rates. A multidisciplinary, multimodal, individualized strategy, collectively termed Patient Blood Management used to minimize or eliminate allogeneic blood transfusion is indicated to improve outcomes.
Description: REVIEW;
metadata.dc.identifier.doi: 10.3748/wjg.v20.i8.1972
ISSN: 1007-9327 (Print)
2219-2840 (Online)
Appears in Collections:01- Artículos - Hospital Virgen de la Victoria

Files in This Item:
File Description SizeFormat 
Munoz_Perioperative.pdfArtículo publiado998,62 kBAdobe PDFView/Open

This item is protected by original copyright

This item is licensed under a Creative Commons License Creative Commons