title: [Permissive anemia].
abstract: Current data demonstrate a lack of support for allogeneic transfusion as a reliable means of delivering oxygen. For the ICU patient tolerance of anemia along with aggressive erythropoitin plus iron therapies can restore hemoglobin levels to normal earlier and with fewer morbidities and possibly enhanced survival than by allogeneic transfusion. Additional evidence on anemia treatment comes from case report studies where transfusions are prohibited and patients survived extremely low hemoglobin levels. While synthetic and bioengineered temporary oxygen carriers may soon be approved for clinical use, the current treatment of anemia remains permissive for the conscientious and informed physician. In the past, anemia meant an almost mandatory transfusion. Now, evidence provides the clinician with sufficient alternatives to treat anemic patients without the use of bank blood products at lower costs with excellent survival and with evidence accumulating to suggest better outcomes.
authors.affiliation: Department of Anesthesia and Intensive Care, Englewood Hospital, NJ 07831, USA.
authors.forename: A
authors.initials: A
authors.lastname: Shander
mesh_terms: D000740:Anemia / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D001804:Blood Transfusion, Autologous; D001810:Blood Volume; D004921:Erythropoietin / Q000008:administration & dosage / Q000627:therapeutic use; D006438:Hemodilution / Q000379:methods; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007362:Intensive Care Units; D033221:Jehovah's Witnesses; D011182:Postoperative Care; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D006454:Hemoglobins; D004921:Erythropoietin