Uceda Torres María Elena, Rodríguez Rodríguez Juan Nicolás, Sánchez Ramos José Luis, Alvarado Gómez Francisco
1 U.G.C. Health Centre "Molino de la Vega ," Huelva, Spain .
J Palliat Med. 2014 Jan;17(1):88-104. doi: 10.1089/jpm.2013.0387. Epub 2013 Dec 10.
Transfusion is not an exceptional circumstance in palliative cancer patients (PCPs). This makes it necessary to confront not only medical aspects but also those of infrastructure and ethical issues. On some occasions, literature needs to be consulted to work out the best approach in a patient's particular case. Our aim was to review the literature contained in PubMed and EMBASE so as to find out about the information available on transfusion in PCPs.
A search for literature was carried out in databases PubMed and EMBASE, using "transfusion," "cancer," "end-of-life care," "terminal care," and "palliative care" as key words. Publications were classified according to the main topic discussed (clinical, infrastructure, and ethics) and the information included in each article critically assessed.
We found 334 articles but only 43 were considered valuable for the present study. Of these 43 articles, 21 deal with clinical topics while 12 deal with infrastructure and 10 with ethical issues. There is an absolute lack of randomized controlled trials or clinical guidelines. Trigger parameters for transfusion are not clearly established. Benefits of the procedure are shortly experienced and remain controversial. Home transfusions are encouraged, but this sole procedure has not been demonstrated to be cost effective. Different cultures, cases, and realities illustrate the diversity of the ethical management of transfusion in PCPs.
Although transfusion is certainly a common practice in PCPs, there is a relative lack of literature on this topic. Publications are unconnected and hardly any prospective studies have been performed. A large part of the little literature available only concerns descriptive and very general aspects of the issue. As transfusional products and financial and human resources are finite, it would be desirable to establish clear research lines on the different aspects considered (clinical, infrastructure, and ethical) that can help clinicians, nurses, patients, and carers to make a decision.
输血在晚期癌症患者中并非罕见情况。这不仅需要应对医学方面的问题，还需处理基础设施和伦理问题。某些情况下，需要查阅文献以确定针对特定患者的最佳治疗方法。我们的目的是回顾PubMed和EMBASE数据库中的文献，以了解有关晚期癌症患者输血的可用信息。
在PubMed和EMBASE数据库中进行文献检索，使用“输血”“癌症”“临终关怀”“终末期护理”和“姑息治疗”作为关键词。根据所讨论的主要主题（临床、基础设施和伦理）对出版物进行分类，并对每篇文章中包含的信息进行严格评估。
我们找到了334篇文章，但只有43篇被认为对本研究有价值。在这43篇文章中，21篇涉及临床主题，12篇涉及基础设施，10篇涉及伦理问题。绝对缺乏随机对照试验或临床指南。输血的触发参数尚未明确确定。该程序的益处短暂且仍存在争议。鼓励家庭输血，但这一单一程序尚未被证明具有成本效益。不同的文化、病例和实际情况说明了晚期癌症患者输血伦理管理的多样性。
尽管输血在晚期癌症患者中确实是一种常见做法，但关于这一主题的文献相对较少。出版物之间缺乏联系，几乎没有进行前瞻性研究。现有少量文献中的很大一部分仅涉及该问题的描述性和非常一般的方面。由于输血产品以及资金和人力资源有限，希望在考虑的不同方面（临床、基础设施和伦理）建立明确的研究方向，以帮助临床医生、护士、患者和护理人员做出决策。
