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Anemia phlebotomy

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https://www.readbyqxmd.com/read/29101207/the-ferroportin-disease-pathogenesis-diagnosis-and-treatment
#1
Antonello Pietrangelo
The Ferroportin Disease is an autosomal dominant hereditary iron loading disorder associated with heterozygote mutations of the ferroportin-1 (FPN) gene. It represents one of commonest cause of genetic hyperferritinemia, regardless of ethnicity. FPN1 transfers iron from the intestine, macrophages and placenta into the bloodstream. In the ferroportin disease, loss-of-function mutations of FPN1 limit but do not impair iron-export in enterocytes, but severely affects iron-transfer in macrophages. This leads to progressive and preferential iron trapping in tissue macrophages, reduced iron release to serum transferrin (i...
November 3, 2017: Haematologica
https://www.readbyqxmd.com/read/29049500/evidence-based-guidelines-to-eliminate-repetitive-laboratory-testing
#2
Kevin P Eaton, Kathryn Levy, Christine Soong, Amit K Pahwa, Christopher Petrilli, Justin B Ziemba, Hyung J Cho, Rodrigo Alban, Jaime F Blanck, Andrew S Parsons
Routine daily laboratory testing of hospitalized patients reflects a wasteful clinical practice that threatens the value of health care. Choosing Wisely initiatives from numerous professional societies have identified repetitive laboratory testing in the face of clinical stability as low value care. Although laboratory expenditure often represents less than 5% of most hospital budgets, the impact is far-reaching given that laboratory tests influence nearly 60% to 70% of all medical decisions. Excessive phlebotomy can lead to hospital-acquired anemia, increased costs, and unnecessary downstream testing and procedures...
October 16, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28804090/repeated-phlebotomies-decrease-body-iron-storage-in-adult-dogs
#3
Seishiro Chikazawa, Fumio Hoshi, Kazutaka Kanai
The aim of the present study was to determine changes in body iron storage in adult dogs following phlebotomy. We performed repeated phlebotomies by removing 1% body weight (approximately 10% of the total blood volume) weekly for a total of 12 times using adult beagle dogs without an iron-restricted diet. After treatment, stored iron was decreased, as demonstrated by gradual reductions in serum ferritin levels and hepatic iron contents. Anemia and abnormalities in blood chemistry analysis were not observed; therefore, this method was considered safe and useful for control of stored iron levels in adult dogs...
October 7, 2017: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/28701427/controlling-phlebotomy-volume-diminishes-picu-transfusion-implementation-processes-and-impact
#4
Katherine Steffen, Allan Doctor, Julie Hoerr, Jeff Gill, Chris Markham, Sarah M Brown, Daniel Cohen, Rose Hansen, Emily Kryzer, Jessica Richards, Sara Small, Stacey Valentine, Jennifer L York, Enola K Proctor, Philip C Spinella
BACKGROUND AND OBJECTIVES: Phlebotomy excess contributes to anemia in PICU patients and increases the likelihood of red blood cell transfusion, which is associated with risk of adverse outcomes. Excessive phlebotomy reduction (EPR) strategies may reduce the need for transfusion, but have not been evaluated in a PICU population. We hypothesized that EPR strategies, facilitated by implementation science methods, would decrease excess blood drawn and reduce transfusion frequency. METHODS: Quantitative and qualitative methods were used...
August 2017: Pediatrics
https://www.readbyqxmd.com/read/28666715/-the-role-of-erythroferrone-in-iron-metabolism-from-experimental-results-to-pathogenesis
#5
N Vallet
In case of erythropoiesis, body iron needs to increase to enable the production of new red blood cells. In the 1950s, the observation of an increased digestive iron absorption in the case of phlebotomies had led to propose the existence of an "erythroid factor", which regulate the availability of iron for erythropoiesis in this situation. The factor regulating iron stores has been identified in 2000 to be hepcidin. Recently, in 2014, a new factor was discovered, which regulates iron metabolism, independently of iron stores and responds to the increased requirements for iron after stimulation of erythropoiesis by erythropoietin...
June 27, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28494509/estimates-of-total-body-iron-indicate-19-mg-and-38-mg-oral-iron-are-equivalent-for-the-mitigation-of-iron-deficiency-in-individuals-experiencing-repeated-phlebotomy
#6
Walter Bialkowski, Joseph E Kiss, David J Wright, Ritchard Cable, Rebecca Birch, Pam D'Andrea, Barbara J Bryant, Bryan R Spencer, Alan E Mast
Iron deficiency anemia is a common clinical condition often treated with tablets containing 65 mg of elemental iron. Such doses can elicit gastrointestinal side effects lowering patient compliance. Oral iron supplements also increase hepcidin production causing decreased fractional absorption of subsequent doses. Frequent blood donors often become iron deficient. Therefore, they were enrolled in a two-year study involving continued blood donations and randomization to receive no pill, placebo, 19, or 38 mg ferrous gluconate for 60 days...
September 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28452910/brief-report-safety-of-frequent-blood-sampling-in-research-participants-in-an-acute-hiv-infection-cohort-in-thailand
#7
Carlo Sacdalan, Trevor Crowell, Donn Colby, Eugène Kroon, Phillip Chan, Suteeraporn Pinyakorn, Nitiya Chomchey, Peeriya Prueksakaew, Suwanna Puttamaswin, Michelle Chintanaphol, Theresa Cheng, Nittaya Phanuphak, Jintanat Ananworanich
INTRODUCTION: Anemia is a potential adverse effect of phlebotomy during participation in research. Clinical studies of acute HIV infection (AHI) require frequent phlebotomy to maximize scientific yield, but this participant population may also be at increased risk for anemia and other adverse events. OBJECTIVE: The objective of this study was to describe baseline and longitudinal hemoglobin changes among participants with AHI. METHODS: Participants with AHI (n = 202) were enrolled in a prospective cohort study in Thailand...
September 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28399115/neonatal-mouse-hippocampus-phlebotomy-induced-anemia-diminishes-and-treatment-with-erythropoietin-partially-rescues-mammalian-target-of-rapamycin-signaling
#8
Diana J Wallin, Tara G Zamora, Michelle Alexander, Kathleen M Ennis, Phu V Tran, Michael K Georgieff
BackgroundPhlebotomy-induced anemia (PIA) is common in premature infants and affects neurodevelopment. PIA alters hippocampal metabolism in neonatal mice through tissue hypoxia and iron deficiency. The mammalian target of rapamycin (mTOR) pathway senses the status of critical metabolites (e.g., oxygen, iron), thereby regulating hippocampal growth and function. We determined the effect of PIA and recombinant human erythropoietin (rHuEpo) treatment on mTOR signaling and expression of genes related to mTOR pathway functions...
September 2017: Pediatric Research
https://www.readbyqxmd.com/read/28362411/continuous-manual-exchange-transfusion-for-patients-with-sickle-cell-disease-an-efficient-method-to-avoid-iron-overload
#9
Bérengère Koehl, Florence Missud, Laurent Holvoet, Ghislaine Ithier, Oliver Sakalian-Black, Zinedine Haouari, Emmanuelle Lesprit, André Baruchel, Malika Benkerrou
Children with sickle cell anemia (SCA) may be at risk of cerebral vasculopathy and strokes, which can be prevented by chronic transfusion programs. Repeated transfusions of packed red blood cells (PRBCs) is currently the simplest and most used technique for chronic transfusion programs. However, iron overload is one of the major side effects of this therapy. More developed methods exist, notably the apheresis of RBC (erythrapheresis), which is currently the safest and most efficient method. However, it is costly, complicated, and cannot be implemented everywhere, nor is it suitable for all patients...
March 14, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27898431/improving-outcome-of-trauma-patients-by-implementing-patient-blood-management
#10
Christoph Füllenbach, Kai Zacharowski, Patrick Meybohm
PURPOSE OF REVIEW: Patient blood management aims to improve patient outcome and safety by reducing the number of unnecessary red blood cell transfusions and vitalizing patient-specific anemia reserves. While this is increasingly recognized as best clinical practice in elective surgery, the implementation in the setting of trauma is restrained because of typically nonelective (emergency) surgery and, in specific circumstances, allogeneic blood transfusions as life-saving therapy. RECENT FINDINGS: Viscoelastic diagnostics allow a precise identification of trauma-induced coagulopathy...
April 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27789107/successful-treatment-of-iron-overload-cardiomyopathy-in-hereditary-hemochromatosis-with-deferoxamine-and-deferiprone
#11
Lydie Tauchenová, Barbora Křížová, Miloš Kubánek, Soňa Fraňková, Vojtěch Melenovský, Jaroslav Tintěra, Dana Kautznerová, Jana Malušková, Milan Jirsa, Josef Kautzner
There is scarce evidence regarding the use of iron chelators in patients with hereditary hemochromatosis who are intolerant of phlebotomy or erythrocytapheresis. A 52-year-old man with genetically confirmed HFE hemochromatosis presented with liver disease and heart failure with severe left ventricular systolic dysfunction. Because of anemia after initial treatment, we added intravenous deferoxamine followed by oral deferiprone to less frequent erythrocytapheresis, which normalized systolic function within 1 year...
December 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27538924/safe-reduction-of-blood-volume-in-the-blood-gas-laboratory
#12
Phillip R Jensen, Boaz A Markewitz
BACKGROUND: Phlebotomy is a significant cause of iatrogenic anemia in the critical care environment. It is estimated that one-third of all transfusions of packed red blood cells in intensive care units (ICU) result from phlebotomy. The aims of this study were to determine if utilizing the 1mL blood gas syringe for an adult population would impact the rate at which specimens were acceptable for testing and result reporting based on lab specimen rejection criteria; and to compare blood utilization between the 2 different syringes...
November 2016: Laboratory Medicine
https://www.readbyqxmd.com/read/27473810/bloodless-medicine-current-strategies-and-emerging-treatment-paradigms
#13
REVIEW
Linda M S Resar, Elizabeth C Wick, Talal Nael Almasri, Elizabeth A Dackiw, Paul M Ness, Steven M Frank
BACKGROUND: Advances in our understanding of the risks associated with allogeneic blood transfusions (ABTs) and the growing number of patients who wish to avoid ABTs have led to the emergence of new treatment paradigms for "bloodless" medicine and surgery. STUDY DESIGN AND METHODS: Here, we review prior studies and summarize current strategies for bloodless care used at our institution. We advocate three basic principles: 1) diagnosing and aggressively treating anemia, 2) minimizing blood loss from laboratory testing and invasive procedures, and 3) identifying and managing bleeding diatheses...
October 2016: Transfusion
https://www.readbyqxmd.com/read/27271482/efficacy-and-safety-of-erythrocytapheresis-and-low-dose-erythropoietin-for-treatment-of-hemochromatosis
#14
Dorothea Brückl, Sundrela Kamhieh-Milz, Julian Kamhieh-Milz, Abdulgabar Salama
BACKGROUND: The aim of this study was to determine retrospectively the efficacy of combined therapy using erythropoietin (EPO) and erythrocytapheresis (EA) in patients with hereditary hemochromatosis (HH) who did not tolerate phlebotomy. PATIENTS AND METHODS: Twenty patients (age range, 43-74 years) with genetically confirmed HH had received low-dose EPO (4,000 IU) in accordance to the patient's hemoglobin levels between each EA session. Laboratory parameters including hemoglobin, ferritin, transferrin, and iron were measured at regular intervals...
June 8, 2016: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/27057839/hepcidin-a-promising-therapeutic-target-for-iron-disorders-a-systematic-review
#15
REVIEW
Jing Liu, Bingbing Sun, Huijun Yin, Sijin Liu
Iron is required for most forms of organisms, and it is the most essential element for the functions of many iron-containing proteins involved in oxygen transport, cellular respiration, DNA replication, and so on. Disorders of iron metabolism are associated with diverse diseases, including anemias (e.g., iron-deficiency anemia and anemia of chronic diseases) and iron overload diseases, such as hereditary hemochromatosis and β-thalassemia. Hepcidin (encoded by Hamp gene) is a peptide hormone synthesized by hepatocytes, and it plays an important role in regulating the systematic iron homeostasis...
April 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/26935514/prevention-of-iatrogenic-anemia-in-critical-and-neonatal-care
#16
REVIEW
Natalia Jakacka, Emilian Snarski, Selamawit Mekuria
Iatrogenic anemia caused by diagnostic blood sampling is a common problem in the intensive care unit, where continuous monitoring of blood parameters is very often required. Cumulative blood loss associated with phlebotomy along with other factors render this group of patients particularly susceptible to anemia. As it has been proven that anemia in this group of patients leads to inferior outcomes, packed red blood cell transfusions are used to alleviate possible threats associated with low hemoglobin concentration...
January 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/26637755/optimizing-hydroxyurea-therapy-for-sickle-cell-anemia
#17
Russell E Ware
Hydroxyurea has proven efficacy in numerous clinical trials as a disease-modifying treatment for patients with sickle cell anemia (SCA) but is currently under-used in clinical practice. To improve the effectiveness of hydroxyurea therapy, efforts should be directed toward broadening the clinical treatment indications, optimizing the daily dosage, and emphasizing the benefits of early and extended treatment. Here, various issues related to hydroxyurea treatment are discussed, focusing on both published evidence and clinical experience...
2015: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/26578290/hospital-acquired-anemia-in-critically-ill-dogs-and-cats-a-multi-institutional-study
#18
MULTICENTER STUDY
A M Lynch, M Respess, A E Boll, M Bozych, M McMichael, D J Fletcher, A M De Laforcade, E A Rozanski
BACKGROUND: Hospital-acquired anemia is commonly described in people but limited information currently is available regarding its prevalence in animals. HYPOTHESIS/OBJECTIVES: Assess the prevalence of hospital-acquired anemia in hospitalized critically ill dogs and cats, and examine its relationship with phlebotomy practices, transfusion administration, and survival to discharge. ANIMALS: Eight hundred and fifty-one client-owned animals (688 dogs and 163 cats)...
January 2016: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/26264778/development-of-anemia-phlebotomy-practices-and-blood-transfusion-requirements-in-45-critically-ill-cats-2009-2011
#19
Anusha Balakrishnan, Kenneth J Drobatz, Erica L Reineke
OBJECTIVE: To describe the incidence of the development of anemia, the number of phlebotomies performed daily, the approximate volume of blood withdrawn, the transfusion requirements and their association with duration of hospitalization and survival to discharge in critically ill cats. DESIGN: Retrospective study from January 2009 to January 2011. SETTING: University teaching hospital. ANIMALS: Cats hospitalized in the intensive care unit (ICU) for >48 hours...
May 2016: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/26164619/impact-of-minimizing-diagnostic-blood-loss-in-the-critically-ill
#20
COMPARATIVE STUDY
Heather S Dolman, Kelly Evans, Lisa Hall Zimmerman, Todd Lavery, Alfred E Baylor, Robert F Wilson, James G Tyburski
BACKGROUND: The use of a small-volume phlebotomy tube (SVPT) versus conventional-volume phlebotomy tube (CVPT) has led to a decrease in daily blood loss. Blood loss due to phlebotomy can lead ultimately to decreased rates of anemia and blood transfusions, which can be important in the critically ill patient. METHODS: We compared SVPT vs CVPT retrospectively in critically ill adult patients age ≥18 years admitted to a surgical intensive care unit for ≥48 hours...
October 2015: Surgery
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