Transfusion therapy for patients critically Ill with cancer

Medical and economic impact of anemia in hospitalized patients

PURPOSE

Studies indicate that the prevalence of anemia in a number of patient populations is more common than originally thought, and that more patients go untreated. Current trends in the prevalence of anemia and the consequences of untreated anemia are described.

SUMMARY

Untreated anemia is linked as an independent risk factor to increased mortality, morbidity, decreased efficacy of chemotherapy and radiotherapy in cancer treatment, and lengthened hospital or intensive care unit length of stay. Anemia is also associated with increased mortality in patients with congestive heart failure or left ventricular dysfunction.

CONCLUSION

Anemia is prevalent in the oncology and critical care populations, yet is a neglected diagnosis. It is well established that anemia has been associated with increased morbidity and mortality, and can adversely impact therapy effectiveness. Effective treatment of anemia should be based on an understanding of the patient's physiological response to anemia and achieving optimal oxygenation levels while minimizing risks and complications common to the critical care patient.

Sepsis

OBJECTIVES

To review infection and sepsis in patients with cancer and to provide an overview of controversies and research-based practices of infectious complications and management strategies.

DATA SOURCES

Research studies, review articles, web sites, and consensus documents.

CONCLUSIONS

Traditional assumptions about infection and its optimal management are redefined by research regarding transfusion and catheter-related infections, prophylactic antibiotic administration, use of growth factors, and antimicrobial therapy regimens.

IMPLICATIONS FOR NURSING PRACTICE

Infection is still the most common source of morbidity and mortality among cancer patients. The importance of recognizing high-risk patients, implementing infection prevention practices, and prompt intervention for infection symptoms has been established.