Department of Physiology, Tribhuvan University, Chitwan Medical College, Post Box No.: 42, Bharatpur-5, Chitwan, Nepal.
Department of Pharmacology, Tribhuvan University, Chitwan Medical College, Bharatpur-5, Chitwan, Nepal.
BMC Palliat Care. 2019 Aug 6;18(1):67. doi: 10.1186/s12904-019-0454-1.
Palliative patients generally present with symptoms of dyspnea, easy fatigability, lethargy and feeling of being unwell which can broadly be attributed to one root cause: cancer-related anemia. So, packed red cell transfusion is often carried out aiming to improve patients' functional status. Different cut off hemoglobin values have been suggested, with Hb < 9 g/dL the most commonly accepted. The present study aims at evaluating and comparing the benefits in subjective symptoms of fatigue and breathlessness among transfused and non-transfused palliative patients on Day 0 and Day 7.
Hemoglobin values, anemia related subjective symptoms of fatigue and breathlessness were recorded from 122 patients. The patients were re-evaluated on day-7 post-transfusion. The pre and post-transfusion symptomatic benefit was compared in both transfused and non-transfused palliative care patients.
The currently practiced hemoglobin trigger for packed red cell transfusion is 10 g/dL. The units of packed red cell to be transfused was decided according to the hemoglobin values targeting the rise to > 10 g/dL. A mean 1.36 units were transfused. Statistically significant improvement was observed in patient reported symptoms of fatigue and breathlessness among both transfused and non-transfused palliative patients.
Anemic cancer palliative patients were found to benefit following packed red cell transfusion, suggesting a favorable association between the transfusion and patient-reported fatigue and dyspnea.
姑息治疗患者通常会出现呼吸困难、易疲劳、嗜睡和不适等症状，这些症状大致可归因于一个根本原因：与癌症相关的贫血。因此，常进行红细胞悬液输注以改善患者的功能状态。不同的血红蛋白截断值已被提出，最常接受的是 Hb<9g/dL。本研究旨在评估和比较输血和未输血的姑息治疗患者在第 0 天和第 7 天的疲劳和呼吸困难主观症状的获益。
记录了 122 例患者的血红蛋白值、与贫血相关的疲劳和呼吸困难的主观症状。在输血后第 7 天对患者进行重新评估。比较了输血和未输血的姑息治疗患者的输血前后的症状获益。
目前实施的红细胞悬液输注血红蛋白触发值为 10g/dL。根据目标血红蛋白值>10g/dL 输注的单位数决定要输注的红细胞悬液单位数。平均输注 1.36 个单位。输血和未输血的姑息治疗患者的疲劳和呼吸困难的患者报告症状均有统计学显著改善。
贫血的姑息治疗癌症患者在输注红细胞悬液后受益，提示输血与患者报告的疲劳和呼吸困难之间存在有利关联。
