Hematology

Download Basics of blood management by Petra Seeber PDF

By Petra Seeber

To minimize transfusion-related morbidity and mortality, it is strongly recommended that an built-in method of blood administration is hired utilizing all to be had instruments to lessen a patient's publicity to donor blood. assembly the necessity for a booklet masking the ideas of blood administration as a pattern in the direction of multidisciplinary blood administration, this new version is a vital source, offering healthcare pros with a device to advance historical past wisdom in blood administration, its association, tools and instruments. practising clinicians should be totally ready to effectively begin and run blood administration courses.

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This was reported mainly in patients on long-term treatment and in those with uremia and myelodysplastic syndromes. While this is very rare, it is a serious side effect. If PRCA occurs, rHuEPO must be stopped immediately. Switching to another brand of rHuEPO does not improve the situation. Actually, rHuEPO is contraindicated if antibodies develop. However, hematide, an EPO-receptor agonist without structural similarity to naturally occurring EPO, may normalize erythropoiesis in PRCA. Another approach to the therapy of PRCA is a short-term regimen of immunosuppressive therapy with corticoids, cyclosporine, cyclophosphamide, immunoglobulins, or plasmapheresis.

A divalent metal transporter 1 (DMT1) is located close to the ferrireductase in the membrane of the enterocytes. This transports iron through the apical membrane of the enterocyte after it has been reduced by the ferrireductase. The absorption of iron in the gut is regulated by several mechanisms. After a meal rich in iron, enterocytes stop taking up iron for a few hours (“mucosal block”), probably “believing” that there is sufficient iron in the body (although this may not be the case). Iron deficiency can cause a two- to threefold increase in iron uptake by the enterocytes.

This may be caused by anemia, lung disease, or high-altitude living. The EPO gene has an enhancer where hypoxic-inducing factor (HIF)-1 (a transcription factor that is induced by hypoxia) attaches and induces EPO gene transcription and subsequent EPO synthesis. Normal EPO levels in non-anemic persons range between 6 and 32 U/L. The levels are similar in men and women. In severe hypoxia or anemia, EPO levels may rise 1000 times above normal. Provided there is enough EPO, basal erythropoiesis may increase six- to eight-fold [7].

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