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Gylvin SH, Jørgensen CC, Fink-Jensen A, Johansson PI, Kehlet H. Psychopharmacologic treatment and blood transfusion in fast-track total hip and knee arthroplasty. Transfusion 2017; 57:971-976. [DOI: 10.1111/trf.13992] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 11/15/2016] [Accepted: 11/15/2016] [Indexed: 12/19/2022]
Affiliation(s)
- Silas Hinsch Gylvin
- Section of Surgical Pathophysiology; Rigshospitalet; Copenhagen Denmark
- Lundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty; Aarhus Denmark
| | - Christoffer Calov Jørgensen
- Section of Surgical Pathophysiology; Rigshospitalet; Copenhagen Denmark
- Lundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty; Aarhus Denmark
| | - Anders Fink-Jensen
- Psychiatric Centre Copenhagen and Laboratory of Neuropsychiatry, Department of Neuroscience and Pharmacology; University of Copenhagen; Copenhagen Denmark
| | - Pär I. Johansson
- Department of Clinical Immunology; Rigshospitalet; Copenhagen Denmark
- Department of Surgery; University of Texas Health Medical School; Houston Texas
- Capital Region Blood Bank; Rigshospitalet; Copenhagen Denmark
| | - Henrik Kehlet
- Section of Surgical Pathophysiology; Rigshospitalet; Copenhagen Denmark
- Lundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty; Aarhus Denmark
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Folléa G. Gestion du sang du patient et pour le patient. Transfus Clin Biol 2016; 23:175-184. [DOI: 10.1016/j.tracli.2016.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 08/22/2016] [Indexed: 12/28/2022]
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Steuber TD, Howard ML, Nisly SA. Strategies for the Management of Postoperative Anemia in Elective Orthopedic Surgery. Ann Pharmacother 2016; 50:578-85. [DOI: 10.1177/1060028016647977] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: To assess the use of oral iron, intravenous (IV) iron, and erythropoiesis-stimulating agents (ESAs) for the prevention and management of perioperative anemia in elective orthopedic surgery patients, and to provide a clinical algorithm for use. Data Sources: A PubMed and MEDLINE search was conducted from 1964 through March 2016 using the following search terms alone or in combination: orthopedic, surgery, elective, anemia, blood transfusion, iron, erythropoiesis-stimulating agents, and erythropoietin.Study Selection and Data Extraction: All English-language prospective and retrospective human studies and meta-analyses evaluating oral iron, IV iron, or ESA alone or in combination in elective orthopedic surgery patients were evaluated, provided they reported blood transfusion outcomes. Data Synthesis: A total of 9 prospective and retrospective studies and 1 meta-analysis were identified and included. In the preoperative setting, administration of oral iron, IV iron, or ESA alone or in combination to correct underlying anemia led to significantly reduced transfusion rates. Transfusion requirements were generally less with combination therapy (ESA + oral or IV iron). In the short-term perioperative or postoperative period, use of oral or IV iron led to conflicting results, with some reporting a statistically significant reduction in blood transfusions, whereas others reported none. Conclusions: In elective orthopedic surgery, IV or oral iron with or without an ESA may provide benefit in prevention of postoperative anemia and results in blood transfusion reduction without significantly increasing the risk of adverse events. These agents should be considered at the lowest effective dose with emphasis on administration prior to planned surgery.
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Affiliation(s)
- Taylor D. Steuber
- Butler University College of Pharmacy and Health Sciences, Indianapolis, IN, USA
- Indiana University Health, Methodist Hospital, Indianapolis, IN, USA
| | - Meredith L. Howard
- University of North Texas System College of Pharmacy, Fort Worth, TX, USA
| | - Sarah A. Nisly
- Butler University College of Pharmacy and Health Sciences, Indianapolis, IN, USA
- Indiana University Health, Methodist Hospital, Indianapolis, IN, USA
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