Lambing Angela, Kachalsky Ellen, Mueller Mary Linda
Hematology/Oncology, Henry Ford Health System, Detroit, MI 48202, USA.
J Am Acad Nurse Pract. 2012 Apr;24(4):175-83. doi: 10.1111/j.1745-7599.2011.00680.x. Epub 2011 Dec 19.
To increase awareness of nurse practitioners (NPs) about the dangers of iron overload and to review common hematologic conditions where transfusions are essential, iron mechanism and transport within the body, effects of iron overload on the body, and treatment options available. Finally, the process for development of a protocol for monitoring such patients will be introduced.
Review of existing literature, myelodysplastic syndrome guidelines, sickle cell guidelines, thalassemia guidelines.
Transfusions of packed red blood cells save lives. There are many hematologic conditions for which packed red blood cell transfusions are required as a result of bone marrow suppression. However, extended exposure to red blood cell transfusions places the patient at an additional risk of iron overload. Iron overload is a real concern for patients who become transfusion dependent, with increased risks of liver cirrhosis and cardiac arrhythmias.
NPs in all areas of practice can increase awareness of the dangers of transfusional iron overload, and become familiar with the treatment options available. Additionally, NPs can institute a monitoring program based on the protocol suggested here within their own practices to prevent poor outcomes for patients with transfusion-related iron overload.
提高执业护士对铁过载危险的认识，并回顾输血必不可少的常见血液学疾病、铁在体内的机制和转运、铁过载对身体的影响以及可用的治疗选择。最后，将介绍制定此类患者监测方案的过程。
现有文献、骨髓增生异常综合征指南、镰状细胞指南、地中海贫血指南。
输注浓缩红细胞可挽救生命。由于骨髓抑制，有许多血液学疾病需要输注浓缩红细胞。然而，长期接受红细胞输血会使患者面临铁过载的额外风险。铁过载是依赖输血患者的一个实际问题，会增加肝硬化和心律失常的风险。
所有执业领域的执业护士都可以提高对输血性铁过载危险的认识，并熟悉可用的治疗选择。此外，执业护士可以在自己的实践中根据此处建议的方案建立一个监测项目，以防止输血相关铁过载患者出现不良后果。
