Perioperative Anemia Management for the Onco-Surgical Patient

2021 ◽  
pp. 541-551
Author(s):  
Michelle McMaster ◽  
Ashish C. Sinha
Keyword(s):  
Surgical Patient ◽  
Anemia Management ◽  
Perioperative Anemia

Perioperative anemia management

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Emilee Borgmeier ◽  
Heather Lawrence ◽  
Colleen Morton ◽  
Matthew D. McEvoy
Keyword(s):  
Anemia Management ◽  
Perioperative Anemia

Perioperative Anemia Management

2019 ◽  
Vol 46 (01) ◽  
pp. 008-016
Author(s):  
Sandaruwani Abeysiri ◽  
Marisa Chau ◽  
Toby Richards
Keyword(s):  
Length Of Hospital Stay ◽  
Transfusion Practice ◽  
World Health ◽  
Current Evidence ◽  
Major Surgery ◽  
Preoperative Anemia ◽  
Anemia Management ◽  
Health Organization ◽  
Perioperative Anemia ◽  
Practice Implementation

AbstractAnemia is increasingly recognized as an interventional hematological target in patients before major surgery. Preoperative anemia increases the need for perioperative blood transfusion, and there is now a well-recognized association with increased patient complications, length of hospital stay, and worse outcomes. Patient Blood Management (PBM) is a World Health Organization endorsed, evidence-based management bundle of care in transfusion hemostasis that focuses on three main aspects: anemia management, prevention of blood loss, and appropriate transfusion practice. Implementation of PBM guidelines has been accompanied by reduced transfusion needs and improved patient outcomes. In a patient presenting with preoperative anemia or at risk of transfusion, this should initiate a program of PBM that manages the patient through the entire operative period. We review the current evidence on the three pillars of PBM and highlight those aspects with the strongest evidence in support of their impact.

Perioperative Anemia Management as Part of PBM in Cardiac Surgery – A Narrative Updated Review

2020 ◽  
Vol 34 (4) ◽  
pp. 1060-1073 ◽  
Author(s):  
Patrick Meybohm ◽  
Sabine Westphal ◽  
Hanne Berg Ravn ◽  
Marco Ranucci ◽  
Seema Agarwal ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Anemia Management ◽  
Perioperative Anemia

Evaluation and treatment of children with radiation-induced cerebral vasculopathy

2019 ◽  
Vol 24 (6) ◽  
pp. 680-688
Author(s):  
David S. Hersh ◽  
Kenneth Moore ◽  
Vincent Nguyen ◽  
Lucas Elijovich ◽  
Asim F. Choudhri ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Proton Beam ◽  
Tumor Imaging ◽  
Clinic Visit ◽  
Surgical Patient ◽  
Beam Radiation ◽  
Proton Beam Radiotherapy ◽  
Cranial Radiation ◽  
Delayed Complication ◽  
Radiation Induced

OBJECTIVEStenoocclusive cerebral vasculopathy is an infrequent delayed complication of ionizing radiation. It has been well described with photon-based radiation therapy but less so following proton-beam radiotherapy. The authors report their recent institutional experience in evaluating and treating children with radiation-induced cerebral vasculopathy.METHODSEligible patients were age 21 years or younger who had a history of cranial radiation and subsequently developed vascular narrowing detected by MR arteriography that was significant enough to warrant cerebral angiography, with or without ischemic symptoms. The study period was January 2011 to March 2019.RESULTSThirty-one patients met the study inclusion criteria. Their median age was 12 years, and 18 (58%) were male. Proton-beam radiation therapy was used in 20 patients (64.5%) and photon-based radiation therapy was used in 11 patients (35.5%). Patients were most commonly referred for workup as a result of incidental findings on surveillance tumor imaging (n = 23; 74.2%). Proton-beam patients had a shorter median time from radiotherapy to catheter angiography (24.1 months [IQR 16.8–35.4 months]) than patients who underwent photon-based radiation therapy (48.2 months [IQR 26.6–61.1 months]; p = 0.04). Eighteen hemispheres were revascularized in 15 patients. One surgical patient suffered a contralateral hemispheric infarct 2 weeks after revascularization; no child treated medically (aspirin) has had a stroke to date. The median follow-up duration was 29.2 months (IQR 21.8–54.0 months) from the date of the first catheter angiogram to last clinic visit.CONCLUSIONSAll children who receive cranial radiation therapy from any source, particularly if the parasellar region was involved and the child was young at the time of treatment, require close surveillance for the development of vasculopathy. A structured and detailed evaluation is necessary to determine optimal treatment.

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