Evaluating Iron Depletion in Pre-Operative Cardiac Patients: Evidence for Changing Practice in a Bloodless Care Center

2.50
Hdl Handle:
http://hdl.handle.net/10755/147313
Type:
Presentation
Title:
Evaluating Iron Depletion in Pre-Operative Cardiac Patients: Evidence for Changing Practice in a Bloodless Care Center
Abstract:
Evaluating Iron Depletion in Pre-Operative Cardiac Patients: Evidence for Changing Practice in a Bloodless Care Center
Conference Sponsor:Sigma Theta Tau International
Conference Year:2003
Author:Torres, Susan
Co-Authors:Ellen Ruth Sorensen, RN, MSN, CNS, CCRN; Jane Bliss-Holtz, DNSc, RNC
Objectives: To develop an evidence-based protocol from existing literature and clinical data that would identify and treat preoperative iron depletion in cardiac surgery patients. Design: This approach integrated an extensive literature review with analysis of available clinical data from 805 cardiac surgery patients. Populations, Sample, Setting: The setting was a 500 bed regional medical center in US Northeast with a comprehensive cardiac surgery and bloodless care program. The sample consisted of all cardiac surgery patients admitted from July 1 through June 30, 2002. The sample was 547 males and 258 females whose mean age was 68 (SD= 9.2) Variables: Levels of preoperative transferrin saturation were examined, with absolute iron deficiency defined as transferrin saturation <20% Methods: An extensive literature review was performed. Additionally, data was analyzed from the National Cardiac database and from patient records. A protocol was developed and tested that included administration of pre- and post-operative iron to patients in the Bloodless Care program. Findings: Existing literature lacks documentation of the incidence of pre-operative iron depletion in healthy adults undergoing cardiac surgery. In this sample, 57% had absolute iron deficiency. There was no significant correlation between hemoglobin and transferrin levels in patients whose hemoglobin was greater than 13 gm, making hemoglobin a poor marker for iron deficiency and erythropoiesis potential. Use of the protocol in the transfusion-free group resulted in significant increases in transferrin saturation on post-operative day 1 and 5 (p=.000). Conclusions: A protocol for identification and treatment of preoperative iron deficiency can aid in avoiding transfusions in practicing bloodless care. Implications: With the blood loss of surgery, evaluation of the patient's erythropoiesis potential is essential, especially in bloodless care programs. Continued evolution of protocols that identify and treat preoperative iron deficiency based on clinical data are needed.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEvaluating Iron Depletion in Pre-Operative Cardiac Patients: Evidence for Changing Practice in a Bloodless Care Centeren_GB
dc.identifier.urihttp://hdl.handle.net/10755/147313-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Evaluating Iron Depletion in Pre-Operative Cardiac Patients: Evidence for Changing Practice in a Bloodless Care Center</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2003</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Torres, Susan</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">susan.torres@leememorial.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Ellen Ruth Sorensen, RN, MSN, CNS, CCRN; Jane Bliss-Holtz, DNSc, RNC</td></tr><tr><td colspan="2" class="item-abstract">Objectives: To develop an evidence-based protocol from existing literature and clinical data that would identify and treat preoperative iron depletion in cardiac surgery patients. Design: This approach integrated an extensive literature review with analysis of available clinical data from 805 cardiac surgery patients. Populations, Sample, Setting: The setting was a 500 bed regional medical center in US Northeast with a comprehensive cardiac surgery and bloodless care program. The sample consisted of all cardiac surgery patients admitted from July 1 through June 30, 2002. The sample was 547 males and 258 females whose mean age was 68 (SD= 9.2) Variables: Levels of preoperative transferrin saturation were examined, with absolute iron deficiency defined as transferrin saturation &lt;20% Methods: An extensive literature review was performed. Additionally, data was analyzed from the National Cardiac database and from patient records. A protocol was developed and tested that included administration of pre- and post-operative iron to patients in the Bloodless Care program. Findings: Existing literature lacks documentation of the incidence of pre-operative iron depletion in healthy adults undergoing cardiac surgery. In this sample, 57% had absolute iron deficiency. There was no significant correlation between hemoglobin and transferrin levels in patients whose hemoglobin was greater than 13 gm, making hemoglobin a poor marker for iron deficiency and erythropoiesis potential. Use of the protocol in the transfusion-free group resulted in significant increases in transferrin saturation on post-operative day 1 and 5 (p=.000). Conclusions: A protocol for identification and treatment of preoperative iron deficiency can aid in avoiding transfusions in practicing bloodless care. Implications: With the blood loss of surgery, evaluation of the patient's erythropoiesis potential is essential, especially in bloodless care programs. Continued evolution of protocols that identify and treat preoperative iron deficiency based on clinical data are needed.</td></tr></table>en_GB
dc.date.available2011-10-26T09:31:09Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T09:31:09Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.