静脉注射治疗贫血的铁3 Perisurgical阶段:回顾和分析当前的文学。

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彼得斯F, Ellermann我,Steinbicker盟

静脉注射治疗贫血的铁3 Perisurgical阶段:回顾和分析当前的文学。

4月Anesth。2018; 126 (4): 1268 - 1282。doi: 10.1213 / ANE.0000000000002591。

PubMed ID

29261547 (在PubMed

]

文摘

贫血是一种常见的疾病在整个住院。治疗方法包括静脉注射(IV)铁、口服铁,促红细胞生成素,红细胞(RBC)输血。IV铁越来越受欢迎与病人血液管理计划的实现。各种研究已经进行调查在术前使用静脉铁,围手术期,术后设置。客观回顾这些研究尚未进行。当前叙事审查概述了试验调查术前静脉注射铁,围手术期,术后设置。我们进行了文学研究的英语文章发表在1964年和2017年3月在Pubmed包括Medline和Cochrane图书馆。只包含研究的对照组。最后的审查包括20个随机对照试验(相关的),7观测试验,5回顾性研究。测量结果包括血红蛋白(Hb)水平,网织红细胞计数,红细胞和/或集中。 Meta-analyses of RCTs using IV iron administration before surgery led to an increase in Hb levels, a reduction of RBC use, and an improvement in patient outcome. Only a few studies investigated the use of IV iron in the perioperative setting. These studies recommended the use of perioperative IV iron in cases of severe anemia in orthopedic surgery but not in all types of surgery. Published RCTs in the postoperative setting have shown positive effects of IV iron on Hb levels, length of hospital stay, and transfusion requirements. Some studies demonstrated an increase of Hb of 0.5-1 g/dL over 4 weeks postoperatively, but the clinical relevance and effect of this increase on an improvement of patient's long-term outcomes are uncertain. To summarize, the evidence to use IV iron is strongest in the preoperative setting, while it remains an individual treatment decision to administer IV iron perioperatively or postoperatively.

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药物靶点

药物	目标	类	生物	药理作用	行动
铁derisomaltose	血红蛋白亚基α	蛋白质	人类	未知的	粘结剂	细节