Top

Published in:

01-06-2020 | Anemia | IM - COMMENTARY

Sparing unnecessary transfusions through patient blood management: time for application also in internal and emergency medicine

Authors: Giacomo Marchi, Fabiana Busti, Domenico Girelli

Published in: Internal and Emergency Medicine | Issue 4/2020

Excerpt

Anemia affects about one-third of the world population with deleterious clinical and economic impact [1]. In our geographical area it is estimated that more than a half of the cases of anemia are due to iron deficiency (ID) [2]. The prevalence of anemia and ID is higher in children, women in childbearing age, pregnancy, and elderly subjects, especially those affected by chronic disorders and multimorbidity [3, 4]. Whatever the cause, ID and anemia can negatively affect various outcomes [5], such as school and working performances, mood, course of pregnancy [6], and prognosis, such as mortality and hospitalizations, in patients with chronic heart failure (CHF) [7], chronic kidney disease (CKD) [8], cancer [9], and in the surgical setting [10]. International guidelines highlight the potential benefits of iron supplementation in CHF, CKD and cancer [11‐13]. …

Smith RE (2010) The clinical and economic burden of anemia. Am J Manag Care 16(Suppl Issues):S59–66

Kassebaum NJ, GBD 2013 Anemia Collaborators (2016) The global burden of anemia. Hematol Oncol Clin N Am 30(2):247–308CrossRef

Girelli D, Marchi G, Camaschella C (2018) Anemia in the elderly HemaSphere 2(3):e40. https://doi.org/10.1097/HS9.0000000000000040 CrossRef

Migone de Amicis M, Poggiali E, Motta I, Minonzio F, Fabio G, Hu C, Cappellini MD (2015) Anemia in elderly hospitalized patients: prevalence and clinical impact. Intern Emerg Med 10(5):581–586CrossRef

Camaschella C, Strati P (2010) Recent advances in iron metabolism and related disorders. Intern Emerg Med 5(5):393–400CrossRef

Breymann C (2015) Iron deficiency anemia in pregnancy. Semin Hematol 52(4):339–347CrossRef

Migone de Amicis M, Chivite D, Corbella X, Cappellini MD, Formiga F (2017) Anemia is a mortality prognostic factor in patients initially hospitalized for acute heart failure. Intern Emerg Med 12(6):749–756CrossRef

Klip IT, Jankowska EA, Enjuanes C, Voors AA, Banasiak W, Bruguera J et al (2014) The additive burden of iron deficiency in the cardiorenal-anaemia axis: scope of a problem and its consequences. Eur J Heart Fail 16(6):655–662CrossRef

Busti F, Marchi G, Ugolini S, Castagna A, Girelli D (2018) Anemia and iron deficiency in cancer patients: role of iron replacement therapy. Pharmaceuticals (Basel) 11(4):E94. https://doi.org/10.3390/ph11040094 CrossRef

10.

Clevenger B, Mallett SV, Klein AA, Richards T (2015) Patient blood management to reduce surgical risk. Br J Surg 102:1325–1337CrossRef

11.

Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS et al (2016) ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Eur Heart J 37(27):2129–2200CrossRef

12.

Kidney Disease: Improving Global Outcomes (KDIGO) Anemia Work Group (2012) KDIGO clinical practice guideline for anemia in chronic kidney disease. Kidney Int Suppl 2:331–335CrossRef

13.

Aapro M, Beguin Y, Bokemeyer C, Dicato M, Gascón P, Glaspy J et al (2018) Management of anaemia and iron deficiency in patients with cancer: ESMO clinical practice guidelines. Ann Oncol 29(Suppl 4):iv96–iv110CrossRef

14.

Meybohm P, Richards T, Isbister J, Hofmann A, Shander A, Goodnough LT et al (2017) Patient blood management bundles to facilitate implementation. Transfus Med Rev 31(1):62–71CrossRef

15.

Spahn DR (2019) Patient blood management what else? Ann Surg 269(5):805–807CrossRef

16.

Shander A, Van Aken H, Colomina MJ, Gombotz H, Hofmann A, Krauspe R et al (2012) Patient blood management in Europe. Br J Anaesth 109:55–68. https://doi.org/10.1093/bja/aes139 CrossRef

17.

Althoff FC, Neb H, Herrmann E et al (2019) Multimodal patient blood management program based on a three-pillar strategy: a systematic review and meta-analysis. Ann Surg 269:794–804CrossRef

18.

Beverina I, Brando B (2019) Prevalence of anemia and therapeutic behaviour in the emergency department at a tertiary care hospital: are patient blood management principles applied? Transfus Apher Sci 58(5):688–692CrossRef

19.

Spradbrow J, Lin Y, Shelton D, Callum J (2017) Iron deficiency anemia in the emergency department: over-utilization of red blood cell transfusion and infrequent use of iron supplementation. CJEM 19(3):167–174. https://doi.org/10.1017/cem.2016.388 CrossRef

20.

Motta I, Mantovan G, Consonni D, Brambilla AM, Materia M, Porzio M et al (2019) Treatment with ferric carboxymaltose in stable patients with severe iron deficiency anemia in the emergency department. Intern Emerg Med. https://doi.org/10.1007/s11739-019-02223-z CrossRef

21.

Girelli D, Ugolini S, Busti F, Marchi G, Castagna A (2018) Modern iron replacement therapy: clinical and pathophysiological insights. Int J Hematol 107(1):16–30. https://doi.org/10.1007/s12185-017-2373-3 CrossRef

22.

Beverina I, Razionale G, Ranzini M, Aloni A, Finazzi S, Brando B (2019) Early intravenous iron administration in the Emergency Department reduces red blood cell unit transfusion, hospitalisation, re-transfusion, length of stay and costs. Blood Transfus 17:1–11. https://doi.org/10.2450/2019.0248-19 CrossRef

23.

Mantadakis E, Roganovic J (2017) Safety and efficacy of ferric carboxymaltose in children and adolescents with iron deficiency anemia. J Pediatr 184:241. https://doi.org/10.1016/j.jpeds.2017.01.041 CrossRef

24.

Busti F, Marchi G, Lira Zidanes A, Castagna A, Girelli D (2019) Treatment options for anemia in the elderly. Transfus Apher Sci 58(4):416–421. https://doi.org/10.1016/j.transci.2019.06.018 CrossRef

25.

Busti F, Marchi G, Girelli D (2019) Iron replacement in inflammatory bowel diseases: an evolving scenario. Intern Emerg Med 14(3):349–351CrossRef

26.

Vossoughi S, Perez G, Whitaker BI, Fung MK, Stotler B (2018) Analysis of pediatric adverse reactions to transfusions. Transfusion 58:60–69. https://doi.org/10.1111/trf.14359 CrossRef

27.

Callum JL, Waters J, Shaz B et al (2014) The AABB recommendations for the choosing wisely campaign of the American Board of Internal Medicine. Transfusion 54:2344–2352CrossRef

28.

Litton E, Xiao J, Ho Kwok M (2013) Safety and efficacy of intravenous iron therapy in reducing requirement for allogeneic blood transfusion: systematic review and meta-analysis of randomised clinical trial. BMJ 347:f4822CrossRef

29.

Quintana-Diaz M, Fara-Cadenas S, Gomez-Ramirez S et al (2016) A fasttrack anaemia clinic in the emergency department: feasibility and efficacy of intravenous iron administration for treating sub-acute iron deficiency anaemia. Blood Transfus 14:126–133

30.

Quintana-Diaz M, Munoz-Romo R, Gomez-Rarmirez S et al (2017) A fast-track anaemia clinic in the emergency department: costanalysis of intravenous iron administration for treating iron deficiency anaemia. Blood Transfus 15:438–446

31.

Khadadah F, Callum J, Shelton D, Lin Y (2018) Improving quality of care for patients with iron deficiency anemia presenting to the emergency department. Transfusion 58(8):1902–1908. https://doi.org/10.1111/trf.14626 CrossRef

32.

Jacob C, Altevers J, Barck I, Hardt T, Braun T, Greiner W (2019) Retrospective analysis into differences in heart failure patients with and without iron deficiency or anaemia. ESC Heart Fail 6:840–855CrossRef

33.

Boone S, Powers JM, Goodgame B, Peacock WF (2019) Identification and management of iron deficiency anemia in the Emergency Department. J Emerg Med 57(5):637–645. https://doi.org/10.1016/j.jemermed.2019.08.052 CrossRef

Title: Sparing unnecessary transfusions through patient blood management: time for application also in internal and emergency medicine
Authors: Giacomo Marchi
Fabiana Busti
Domenico Girelli
Publication date: 01-06-2020
Publisher: Springer International Publishing
Keywords: Anemia
Emergency Medicine
Iron Deficiency
Chronic Heart Failure
Published in: Internal and Emergency Medicine / Issue 4/2020
Print ISSN: 1828-0447
Electronic ISSN: 1970-9366
DOI: https://doi.org/10.1007/s11739-020-02278-3

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

2024 ASCO Annual Meeting

Springer Medicine

Excerpt

Please log in to get access to this content

Other articles of this Issue 4/2020

An unusual case of inferior vena cava thrombosis: widening the differential diagnosis

Prevalence and clinical impact of VIral Respiratory tract infections in patients hospitalized for Community-Acquired Pneumonia: the VIRCAP study

Incidence of hyperkalemia in the emergency department: a 10-year retrospective study

Considerations about turmeric-associated hepatotoxicity following a series of cases occurred in Italy: is turmeric really a new hepatotoxic substance?

Trends in antimicrobial resistance among bacteria causing septic arthritis in adults in a single center: A 15-years retrospective analysis

Vaping effects on asthma: results from a web survey and clinical investigation

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

At a glance: The STEP trials