Document Detail


Erythropoiesis, erythropoietin, and iron metabolism in elective surgery: preoperative strategies for avoiding allogeneic blood exposure.
MedLine Citation:
PMID:  8546246     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Preoperative autologous donation (PAD) of blood and administration of recombinant human erythropoietin (Epoetin alfa) are two strategies for increasing red blood cell (RBC) mass preoperatively. The success of PAD depends primarily on the patient's ability to manufacture new RBCs before surgery to replace those removed during PAD. Red blood cell manufacture depends in turn on adequate supplies of iron and the increased renal production of endogenous erythropoietin following PAD. Successful PAD also requires adequate time for regeneration of predonated RBCs. Parenteral administration of Epoetin alfa causes a dose-dependent stimulation of RBC production. Its use has been studied as an adjunct to PAD and as a method to enhance endogenous erythropoiesis without PAD. Several studies suggest that administration of Epoetin alfa, begun several days before surgery, may stimulate erythropoiesis and help decrease the number of RBC transfusions required postoperatively. The precise role of Epoetin alfa in the surgical setting is not yet established, and optimal dosage regimens have not been determined.
Authors:
M A Goldberg
Related Documents :
10927206 - The efficacy of autologous blood transfusion in bilateral total knee arthroplasty.
1609516 - A study of autologous blood collected after joint replacement surgery.
18507216 - Acute normovolaemic haemodilution--is it a solution to reduce perioperative blood trans...
18091536 - Effects of hypertonic/hyperoncotic treatment and surgical evacuation after acute subdur...
20351006 - Changes in neonatal transfusion practice after dissemination of neonatal recommendations.
16712736 - Long-term clearance from small airways in subjects with ciliary dysfunction.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of surgery     Volume:  170     ISSN:  0002-9610     ISO Abbreviation:  Am. J. Surg.     Publication Date:  1995 Dec 
Date Detail:
Created Date:  1996-02-13     Completed Date:  1996-02-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  37S-43S     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Anemia / prevention & control*
Blood Transfusion, Autologous*
Drug Administration Schedule
Erythrocyte Transfusion
Erythropoiesis / drug effects*,  physiology
Erythropoietin / administration & dosage*,  pharmacokinetics
Female
Ferritins / blood
Humans
Inflammation / physiopathology
Male
Osteoarthritis / surgery
Postoperative Complications / prevention & control*
Preoperative Care
Recombinant Proteins / administration & dosage,  pharmacokinetics
Surgical Procedures, Elective*
Chemical
Reg. No./Substance:
0/Recombinant Proteins; 11096-26-7/Erythropoietin; 9007-73-2/Ferritins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Morbidity risk assessment in the surgically anemic patient.
Next Document:  A physiologic basis for red blood cell transfusion decisions.