scholarly journals Changes in Cerebral Oxygenation Associated with Intradialytic Blood Transfusion in Patients with Severe Anemia Undergoing Hemodialysis

Nephron Extra ◽  
2017 ◽  
Vol 7 (1) ◽  
pp. 42-51 ◽  
Author(s):  
Kiyonori Ito ◽  
Susumu Ookawara ◽  
Yuichiro Ueda ◽  
Haruhisa Miyazawa ◽  
Masaya Kofuji ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Cerebral Oxygenation ◽  
Severe Anemia

scholarly journals Association between Intraoperative Blood Transfusion and Mortality and Morbidity in Patients Undergoing Noncardiac Surgery

2011 ◽  
Vol 114 (2) ◽  
pp. 283-292 ◽  
Author(s):  
Laurent G. Glance ◽  
Andrew W. Dick ◽  
Dana B. Mukamel ◽  
Fergal J. Fleming ◽  
Raymond A. Zollo ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Noncardiac Surgery ◽  
Pulmonary Complications ◽  
Wound Complications ◽  
Severe Anemia ◽  
Thromboembolic Complications ◽  
Mortality And Morbidity ◽  
Risk Of Death ◽  
Increased Risk ◽  
The Impact

Background The impact of intraoperative erythrocyte transfusion on outcomes of anemic patients undergoing noncardiac surgery has not been well characterized. The objective of this study was to examine the association between blood transfusion and mortality and morbidity in patients with severe anemia (hematocrit less than 30%) who are exposed to one or two units of erythrocytes intraoperatively. Methods This was a retrospective analysis of the association of blood transfusion and 30-day mortality and 30-day morbidity in 10,100 patients undergoing general, vascular, or orthopedic surgery. We estimated separate multivariate logistic regression models for 30-day mortality and for 30-day complications. Results Intraoperative blood transfusion was associated with an increased risk of death (odds ratio [OR], 1.29; 95% CI, 1.03-1.62). Patients receiving an intraoperative transfusion were more likely to have pulmonary, septic, wound, or thromboembolic complications, compared with patients not receiving an intraoperative transfusion. Compared with patients who were not transfused, patients receiving one or two units of erythrocytes were more likely to have pulmonary complications (OR, 1.76; 95% CI, 1.48-2.09), sepsis (OR, 1.43; 95% CI, 1.21-1.68), thromboembolic complications (OR, 1.77; 95% CI, 1.32-2.38), and wound complications (OR, 1.87; 95% CI, 1.47-2.37). Conclusions Intraoperative blood transfusion is associated with a higher risk of mortality and morbidity in surgical patients with severe anemia. It is unknown whether this association is due to the adverse effects of blood transfusion or is, instead, the result of increased blood loss in the patients receiving blood.

A case study of an older adult with severe anemia refusing blood transfusion

2007 ◽  
Vol 19 (1) ◽  
pp. 43-48 ◽  
Author(s):  
C. Michelle Thomas ◽  
Harriet R. Coleman ◽  
Leslie-Faith Morritt Taub
Keyword(s):  
Blood Transfusion ◽  
Older Adult ◽  
Severe Anemia

scholarly journals Case Report of Rare cause of Acute Hemolytic Anemia in Saudi Patient (Babesiosis)

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Khadiga Ahmed Ismail
Keyword(s):  
Case Report ◽  
Blood Transfusion ◽  
Infected Patient ◽  
Immune Status ◽  
Antimicrobial Treatment ◽  
Zoonotic Diseases ◽  
Severe Anemia ◽  
Clinical Presentations ◽  
Discharge From Hospital ◽  
Clinical Conditions

Babesiosis is one of the protozoan zoonotic diseases its presentation rang from asymptomatic to severe clinical conditions, with severe hemolysis. Immune status of the host and the species of the parasite has impact on the clinical presentations of the infected patient our patient is presented here; the patient was admitted from a countryside with severe anemia and a deterioration in his general condition, he was admitted to intense care unit and received blood transfusion, in addition to antimicrobial treatment in form of azithromycin and Ceftriaxon, his condition improve and released from ICU on the second day and discharge from hospital after improvement on the seventh day.

Use of a hemoglobin substitute in the anemic Jehovah's Witness patient

1994 ◽  
Vol 14 (1) ◽  
pp. 31-38 ◽  
Author(s):  
TR Marelli
Keyword(s):  
Blood Transfusion ◽  
Oxygen Transport ◽  
Oxygen Delivery ◽  
Severe Anemia ◽  
Transfusion Therapy ◽  
Acute Anemia ◽  
First Choice ◽  
Religious Convictions ◽  
Effective Drugs ◽  
Witness Patient

Fluosol DA is an experimental means of supplementing oxygen delivery in the anemic patient. The drug's ability to improve oxygen transport appears to improve SVO2. Blood transfusion is the first choice for acute anemia secondary to hemorrhage; however, perfluorochemicals offer an alternative for the patient who cannot accept transfusion therapy. This article reports a case of severe anemia in which transfusion was refused because of the patient's religious convictions. Perfluorochemicals represented an effective medical treatment that was compatible with this patient's religious beliefs. Continued research in artificial oxygen transporters may lead to even more effective drugs for the treatment of acute anemia, possibly decreasing the need for blood transfusion for all patients.

A Comparative Study of Conventional vs Rapid Speed of Blood Transfusion in Cases of Chronic Severe Anemia

Angiology ◽  
1985 ◽  
Vol 36 (9) ◽  
pp. 617-621 ◽  
Author(s):  
Nitya Nand ◽  
M.S. Gupta ◽  
J.C. Bhutani ◽  
S.P. Gupta ◽  
M. Sharma
Keyword(s):  
Blood Transfusion ◽  
Comparative Study ◽  
Severe Anemia

Cancer Related Anemia in the Era of Erythropoietin Stimulating Agents (ESA)Uncertainty: A Single Cancer Institution Experience.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 5085-5085
Author(s):  
Hikmat Abdel-Razeq ◽  
Shadi B Hijjawi ◽  
Hazem Abdulelah ◽  
Yousef Ismael ◽  
Rula Amarin ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Combined Treatment ◽  
Disease Stage ◽  
Severe Anemia ◽  
Primary Cancer ◽  
Mild Anemia ◽  
Erythropoietin Stimulating Agents ◽  
Prevalence Of Anemia

Abstract Abstract 5085 Anemia is the most common hematological abnormality in cancer patients. Unfortunately, it is often under-recognized and under-treated. The pathogenesis of cancer anemia is complex and most of the time multifactorial; involving factors related to the tumor itself or its therapy. Recombinant human erythropoietin stimulating agents (ESA) was widely used to prevent and treat cancer and chemotherapy-related anemia. However, many recent studies involving patients with different kind of cancers at different stages of their disease suggested a negative impact on disease progression and survival when such ESA were used to keep Hemoglobin (Hb) at a higher level. The US Food and Drug Administration (FDA) announced revisions and warning to restrict ESA indications. This report describes the prevalence of anemia in cancer patients and its management given the recent confusion and uncertainties. Methods We retrospectively reviewed all consecutive adult cancer patients admitted to regular medical units between Jan and Dec, 2008. Patients admitted to Leukemia, Bone Marrow Transplantation and Intensive Care Units were excluded. Demographic features, reasons for admission, primary cancer diagnosis and disease stage were determined. All patients with Hb value < 12 g/dL at any time during admission were considered anemic. Treatment offered for anemia was also reviewed. Subsequent admissions for the same patients during the study period were also followed up. Results 959 patients (51% males, median age 55 years, range 18- 91) admitted 1862 times were included. Reasons for admission at time of enrollment included chemotherapy (23%), infections including neutropenic fever (20%), palliative and supportive care (15%). Other reasons included pulmonary, neurological, renal and electrolyte imbalances. Primary cancer diagnosis included: Gastrointestinal (21%), Breast (16%), Lymphoma and Multiple Myeloma (16%), and Lung (11%). At time of enrollment, 55% of patients had advanced stage disease. Anemia at any time during admission was detected in 755 (78.7%) patients. Mean Hb value for anemic patients was 9.51 g/dL (range 3.5-11.9, median 9.6). Severe anemia (Hb < 8) was documented in 16.7%, moderate anemia (Hb 8-10) in 41.9% and mild anemia (Hb > 10) in 41.5% of the patients. Majority (69%) of the patients were not offered any treatment for their anemia. Among the total group, blood transfusion was offered for 25%, supplements (including iron, folate and or vitamin B12) for 3.3%. ESA were offered for only 1.1%. Few patients (2.1%) had combined treatment. Mean Hb value at which treatment was started was 8 g/dL, while mean Hb for the patients who were not treated was 10.2 g/dL. Most of the patients (94%) with severe anemia, 32% with the moderate, and 5% of the patients with mild anemia were treated as shown in the table. Conclusions Anemia among adult cancer patients admitted to regular medical units is quiet common. Given the recent FDA warning and the many confusing studies, the prevalence of anemia in cancer patients was found to be high; many of such patients were not offered any treatment. The threshold to start treatment was highly dependent on its severity. Blood transfusion was the most common treatment method. Quality improvement projects should be implemented to better recognize and treat anemia in cancer patients. Disclosures No relevant conflicts of interest to declare.

Administration of Minihepcidins to Animals Affected By β-Thalassemia Major Reduces Anemia and Splenomegaly

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 259-259
Author(s):  
Roberta Chessa ◽  
Ritama Gupta ◽  
Carla Casu ◽  
Robert E Fleming ◽  
Yelena Ginzburg ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Transferrin Saturation ◽  
Thalassemia Major ◽  
New Drugs ◽  
Severe Anemia ◽  
Globin Genes ◽  
Thalassemia Intermedia ◽  
Require Blood Transfusion ◽  
Ineffective Erythropoiesis

Abstract Both β-thalassemia intermedia and major are characterized by formation of hemichromes in erythroid cells, impairing their survival and the lifespan of red blood cells (RBC). Minihepcidins (MH) are novel compounds that function as hepcidin agonists and reduce iron absorption and transferrin saturation. Hbbth3/+ mice show features of β-thalassemia intermedia, such as ineffective erythropoiesis (IE), anemia and reduced hepcidin synthesis, but do not require blood transfusion for survival (non-transfusion dependent thalassemia or NTDT). As we have previously shown, the administration of MH in these animals decreased transferrin saturation, erythroid iron intake, heme synthesis and hemichrome formation, with a significant beneficial effect on RBC quality, lifespan and anemia (Casu et al, Blood 2016). In order to test if this approach could also benefit animals affected by β-thalassemia major we focused on generating a model that exhibited a low production of RBCs, severe anemia and a blood transfusion requirement for survival, as in patients affected by transfusion dependent thalassemia or TDT. We have previously shown that engraftment of Hbbth3/th3fetal liver cells (FLCs) into normal mice leads to a very severe anemia that requires blood transfusion for survival (Gardenghi et al, Blood 2007). However, Hbbth3/th3FLCs do not contain any adult or fetal-globin genes and are unable to make hemoglobin in the transplanted animals, in contrast to human β-thalassemia. Therefore, animals cannot benefit from therapies that decrease hemichrome formation and target IE such as MH. To overcome this limitation, we crossed Hbbth3/+mice with additional models of NTDT, indicated as Hbbth1/th1and Hbbth2/+. These mice harbor alternative mutations so that the synthesis of the mouse b-globin genes is different in each model. Hbbth1/th2and Hbbth1/th3pups were alive at birth, but unable to survive more than a couple of days even with the support of blood transfusion. However, recipient transgenic animals expressing GFP and engrafted with Hbbth1/th2andHbbth1/th3FLCs showed the desired phenotype 3 months post-transplant including production of GFP- RBCs (with less than 2% of host GFP+ RBC) and a different degree of anemia, respectively 5.6±0.5 g/dL and 3.1±1.5 g/dL. In the long term these animals require blood transfusion for survival. Therefore these models are useful to test drugs that have the potential to modify erythropoiesis and RBC production. Ten weeks following engraftment with Hbbth1/th2FLCs, mice were treated for six weeks with two different doses of MH (5.25 mg/kg and 2.625 mg/kg administered every other day) in absence of blood transfusion. Animals treated with vehicleshowed severe ineffective erythropoiesis and worsening anemia over 6 weeks (from 5.6±0.5 g/dL on D0 to 5.0±0.7 g/dL on D42 of treatment). In contrast, animals treated with MH showed reversal of anemia at 3 weeks (6.6±0.3 g/dL and 6.1±0.6 g/dL in the 5.25 mg/kg and 2.625 mg/kg group, respectively, compared to 5.3±0.9 g/dL in controls), while at 6 weeks the differences were reduced compared to vehicle treated mice (6.0±0.4 g/dL and 5.7±0.5 g/dL in the 5.25 mg/kg and 2.625 mg/kg group, respectively, compared to 4.9±0.7 g/dL in controls). The RBC number followed the same trend. Furthermore, the RBC morphology of animals treated with MH was improved compared to control animals. At 6 weeks, splenomegaly was also improved in the treatment groups (13.8±2.7 mg and 16.9±2.7 mg respectively in the 5.25 mg/Kg and 2.625 mg/Kg group compared to 26.9±3.5 mg in controls). Comparing the data at 3 versus 6 weeks, we speculate that, while the MH has a positive effect on RBC quality and production, this is insufficient, in the long term, to prevent the severe splenomegaly and the consequent entrapment of the RBC, which exacerbates the anemia over time. However, we hypothesized that administration of MH could have longer lasting beneficial effects in presence of blood transfusion, which would limit the splenomegaly. Presently, we are testing this hypothesis using both the Hbbth1/th2and Hbbth1/th3models. Complete characterization of these models and their parameters (CBC, erythropoiesis, iron metabolism and organ iron content) is in progress. In conclusion, these models can be utilized to characterize severe thalassemia phenotypes and new drugs that have the potential to ameliorate IE and improve RBCs generation. Disclosures MacDonald: Merganser: Employment, Equity Ownership, Membership on an entity's Board of Directors or advisory committees.

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