Current misconceptions in diagnosis and management of iron deficiency

被引:78
作者
Munoz, Manuel [1 ]
Gomez-Ramirez, Susana [2 ]
Besser, Martin [3 ]
Pavia, Jose [4 ]
Gomollon, Fernando [5 ]
Liumbruno, Giancarlo M. [6 ]
Bhandari, Sunil [7 ,8 ]
Cladellas, Merce [9 ]
Shander, Aryeh [10 ]
Auerbach, Michael [11 ]
机构
[1] Univ Malaga, Sch Med, Dept Surg Sci Biochem & Immunol, Perioperat Transfus Med, Malaga, Spain
[2] Univ Hosp Virgen de la Victoria, Dept Internal Med, Malaga, Spain
[3] Cambridge Univ Hosp NHS Fdn Trust, Dept Haematol, Cambridge, England
[4] Univ Malaga, Sch Med, Dept Pharmacol, Malaga, Spain
[5] Univ Hosp Lozano Blesa, Dept Gastroenterol, IIS Aragon, CIBERehd, Zaragoza, Spain
[6] Natl Inst Hlth, Italian Natl Blood Ctr, Rome, Italy
[7] Hull & East Yorkshire Hosp NHS Trust, Metabol Res Unit, Kingston Upon Hull, Yorks, England
[8] Hull York Med Sch, Kingston Upon Hull, Yorks, England
[9] Univ Hosp Mar Esperanca, Biomed Res Inst, Barcelona, Spain
[10] Englewood Hosp & Med Ctr, Dept Anesthesiol Crit Care Med Pain Management &, TeamHlth Res Inst, Englewood, NJ USA
[11] Georgetown Univ, Sch Med, Washington, DC USA
关键词
iron deficiency; anaemia; oral iron; intravenous iron; misconceptions; PATIENT BLOOD MANAGEMENT; INFLAMMATORY-BOWEL-DISEASE; INTRAVENOUS FERRIC CARBOXYMALTOSE; CHRONIC KIDNEY-DISEASE; INCREASE PREOPERATIVE HEMOGLOBIN; PERIOPERATIVE ANEMIA MANAGEMENT; ISOMALTOSIDE 1000 MONOFER(R); CHEMOTHERAPY-INDUCED ANEMIA; RANDOMIZED CONTROLLED-TRIAL; MAJOR ORTHOPEDIC-SURGERY;
D O I
10.2450/2017.0113-17
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The prevention and treatment of iron deficiency is a major public health goal. Challenges in the treatment of iron deficiency include finding and addressing the underlying cause and the selection of an iron replacement product which meets the needs of the patient. However, there are a number of non-evidencebased misconceptions regarding the diagnosis and management of iron deficiency, with or without anaemia, as well as inconsistency of terminology and lack of clear guidance on clinical pathways. In particular, the pathogenesis of iron deficiency is still frequently not addressed and iron not replaced, with indiscriminate red cell transfusion used as a default therapy. In our experience, this imprudent practice continues to be endorsed by non-evidence-based misconceptions. The intent of the authors is to provide a consensus that effectively challenges these misconceptions, and to highlight evidence-based alternatives for appropriate management (referred to as key points). We believe that this approach to the management of iron deficiency may be beneficial for both patients and healthcare systems. We stress that this paper solely presents the Authors' independent opinions. No pharmaceutical company funded or influenced the conception, development or writing of the manuscript.
引用
收藏
页码:422 / 437
页数:16
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