HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Perioperative anemia management in colorectal cancer patients: a pragmatic approach.

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.
AuthorsManuel Muñoz, Susana Gómez-Ramírez, Elisa Martín-Montañez, Michael Auerbach
JournalWorld journal of gastroenterology (World J Gastroenterol) Vol. 20 Issue 8 Pg. 1972-85 (Feb 28 2014) ISSN: 2219-2840 [Electronic] United States
PMID24587673 (Publication Type: Journal Article, Review)
Chemical References
  • Erythropoietin
  • Iron
  • Oxygen
Topics
  • Algorithms
  • Anemia (therapy)
  • Blood Transfusion
  • Colorectal Neoplasms (complications, therapy)
  • Erythropoietin (therapeutic use)
  • Europe
  • Female
  • Humans
  • Iron (therapeutic use)
  • Male
  • Oxygen (chemistry)
  • Perioperative Care (adverse effects)
  • Perioperative Period
  • Quality of Life

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: