Prophylactic administration of hematinics (iron, folic acid, vitamin B12) should always be considered.2

1 -Treatment of iron deficiencies

– Intravenous (IV) iron by saline infusion, for example, iron hydroxide saccharate

(dosage of 3 to 5 mg/kg/day and the maximum of 200 mg/day) or carboxymaltose

(dosage 15 mg/kg and maximum of 1,000 mg in single infusion) can rapidly replenish

iron reserves.

2 – Oral iron: sacarato de hidróxido férrico (200 mg/day) ou glicinato férrico (300-

500 mg/day).

Recombinant human erythropoietin (r-Hu- EPO) therapy

– Standard dose in adult: 600 IU / kg / week. For example: Patient of 70 kg, apply

intravenous 42,000 IU / week after dilution in 50 ml of SF 0.9%.

– Higher doses in adult: 150-300 UI / kg in intervals of 24-72 hours: poor response

to erythropoiesis-stimulating therapy includes iron deficiency as well as infectious,

inflammatory or malignant processes, occult blood loss, hyperparathyroidism and

hematologic diseases

– Dose in children: 200 IU / kg /day (1,400 IU / kg/ week in divided dosages) has

been shown to be safe and well tolerated by children.

For severe acute anemia, critical illnesses, deficiency in subcutaneous absorption

(due to edema or blood flow alterations) consider initial IV administration of r-Hu- EPO

followed by subcutaneous dosages.

Aggressive anemia therapy must not be delayed until the hemoglobin levels fall and

reach critically low levels.

Protocol

Anemia Treatment and Erythropoietin therapy Guidelines

Protocol based on scientific evidence for the non-transfusional treatment of anemia through the appropriate use of iron and erythropoietin.

Welcome to Bloodless

Background:

Blood transfusions are currently one of the most performed medical procedures in the world. However, the medical literature shows a relationship between the use of allogeneic (donated) blood and greater complications, including, greater mortality. Worldwide, there is a deficiency in medical knowledge about transfusion practice.

Objectives:

1. To change the current transfusion practice, through the application of scientifically safe and effective PROTOCOLS for the TREATMENT OF ANEMIA and MANAGEMENT OF BLEEDING without the use of allogeneic blood, based on the scientific evidence of modern medicine.

2. Help blood banks SAVE their main HEMOCOMPONENTS (red blood cells, plasma and platelets)