在严重烧伤非手术输注中静脉铁的作用。

Q3 Medicine Annals of burns and fire disasters Pub Date : 2020-12-31
J Carbajal-Guerrero, P Gacto-Sanchez, M Mendoza-Prieto, A Cayuela-Dominguez, J Manuel Lopez-Chozas
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引用次数: 0

摘要

由于失血和慢性炎症,贫血是烧伤患者的常见症状。输血增加了严重感染的可能性,降低了总体生存率,特别是与围手术期失血无关的情况下。一旦烧伤患者的手术阶段完成,肠外给铁在减少后续输血中的作用尚未得到很好的确定。选择至少接受两次手术且在手术期结束后出现进行性贫血且无主要症状的烧伤患者(n=12)。证实缺铁的患者采用静脉注射(i.v.)羧麦芽糖铁治疗(n=8)。随后,将这些患者与从我们的历史数据库中选择的18例对照患者(n=1375)进行比较,这些对照患者按年龄(±5岁)、性别和TBSA烧伤(±6%)进行匹配。目的是验证输注铁是否能减少手术后的输血需求。分析得出的结论是,与44%的对照组相比,接受治疗的病例中没有一例需要输血。没有与静脉输铁有关的副作用。这一结果表明,静脉补铁与三羧基麦芽糖铁可能是一种替代贫血患者的主要症状,一旦手术阶段完成。应评估缺铁情况,如果出现进行性贫血的烧伤患者需要,必须静脉补充铁。
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Role Of Intravenous Iron Over Nonsurgical Transfusions In Major Burns.

Anemia is a frequent condition in burn patients due to a mixture of blood loss and chronic inflammation. Transfusions increase the probability of serious infections and reduce overall survival, especially when unrelated to perioperative blood loss. Once the surgical phase in burn patients is completed, the role of parenteral iron administration in the reduction of subsequent transfusions is not well established. Burn patients subjected to at least two surgeries and presenting progressive anemia after concluding the surgical phase, without major symptoms, were selected (n=12). Those patients with confirmed iron deficiency were treated with intravenous (i.v.) ferric carboxymaltose (n=8). Subsequently, these patients were compared with a group of 18 control patients selected from our historical database (n=1375), matching controls by age (±5 years), sex, and TBSA burn (±6%). The objective was to verify if i.v. iron administration reduced the need for blood transfusions after the surgical phase. The analysis concluded that none of the cases treated required transfusions compared to 44% of the controls. There were no side effects related to the i.v. iron infusion. This result suggests that i.v. iron supplementation with ferric carboxymaltose could be an alternative in anemic patients without major symptoms once the surgical phase is completed. Iron deficiency should be assessed and i.v. supplementation must be administered if required in burn patients showing progressive anemia.

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来源期刊
Annals of burns and fire disasters
Annals of burns and fire disasters Nursing-Emergency Nursing
CiteScore
1.20
自引率
0.00%
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0
期刊介绍: "Annals of Burns and Fire Disasters" is the official publication of the Euro-Mediterranean Council for Burns and Fire Disasters (MBC) and the European Burns Association (EBA). It is a peer-reviewed journal directed to an audience of medical as well as paramedical personnel involved in the management of burn injuries. The journal publishes original articles in the form of clinical and basic research, scientific advances. It publishes also selected abstracts from international journals.
期刊最新文献
MBC Report. SFB. Investigation Of Common Burn Mechanisms, And Training And Safety Conditions In The Workplace. Brûlure Et Atteinte Oculaire: Incidence, Facteurs De Risque Et Pronostic. Brûlures Profondes Des Membres Inférieurs Chez Les Patients Diabétiques: À Propos De 30 Cas.
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