Practical Anemia Bundle and Hemoglobin Recovery in Critical Illness

作者：Matthew A. Warner, Matthew L. Johnson, Andrew C. Hanson, Emma Fortune, Gerald W. Flaby, Phillip J. Schulte, Valerie M. Hazelton, Ronald S. Go, William B. Beam, Jonathan E. Charnin, Brenda Anderson, Brad S. Karon, Andrea Cheville, Ognjen Gajic, Daryl J. Kor · 发表于：JAMA Network Open · 年份：2025 · DOI：10.1001/jamanetworkopen.2025.2353 · 被引用次数：11 · 研究领域：Blood transfusion and management、Iron Metabolism and Disorders、Erythropoietin and Anemia Treatment

Importance: Anemia is a common complication of surgery and acute illness that is associated with adverse clinical outcomes. The role of anemia prevention and treatment strategies in this setting remains unclear. Objective: To evaluate the effect of a multifaceted anemia management bundle vs standard care on posthospitalization hemoglobin recovery and multidimensional functional outcomes in survivors of acute illness. Design, Setting, and Participants: This parallel group randomized clinical trial, known as the Practical Anemia Bundle for Sustained Blood Recovery, was conducted at postsurgical and medical intensive care units at a large US medical center. Critically ill patients (aged ≥18 years) with moderate to severe anemia (hemoglobin concentration <10 g/dL) were enrolled between March 2022 and November 2023. Participants were randomly assigned 1:1 to the intervention or standard care group. Intention-to-treat analyses were performed between July 2024 and January 2025. Intervention: The intervention bundle was delivered throughout the duration of hospitalization and included optimized phlebotomy practices, clinical decision support, and pharmacological anemia treatment with intravenous iron. Main Outcomes and Measures: The primary outcome was the mean difference in hemoglobin concentration at 1 month after hospital discharge. Results: A total of 100 patients (median [IQR] age, 68 [61-72] years; 57 men [57.0%]; 65 [65.0%] with postsurgical admission to the intensive care uni...