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Stanley J. Dudrick, MD; Joseph J. O'Donnell, MD; Denis P. Raleigh, MD; Robert G. Matheny, MD; Steven P. Unkel, MD

Arch Surg. 1985;120(6):721-727.

Abstract
• Optimal parenteral nutritional support, concomitant with replacement doses of intravenous iron dextran injection, can be safe, effective, and lifesaving for severely anemic patients who are unable to receive blood transfusions. Six patients who had sustained massive acute blood loss and two who had severe chronic anemia received as much as 140 mL of iron dextran injection intravenously. The average initial hemoglobin level in the acute group was 5.0 g/dL (range, 2.6 to 8.4 g/dL) and increased to an average of 10.6 g/dL (range, 7.5 to 12.8 g/dL) in 23 days (range, 17 to 30 days); the hemoglobin level in the chronic group was 3.8 g/dL and increased to 10.6 g/dL over an average period of 121 days. Two total abdominal colectomies, a right transverse colectomy and fistulectomy, a pyloroplasty and vagotomy, and a highly selective vagotomy were accomplished without complications in five of the patients. There were no adverse reactions to the hematopoietic therapy.

(Arch Surg 1985;120:721-727)

Author Affiliations
From the Departments of Surgery and Surgical Nutrition, St Luke's Episcopal Hospital, Houston (Drs Dudrick, Raleigh, and Unkel); the Department of Surgery, University of Texas Medical School at Houston (Drs Dudrick and O'Donnell); and the Department of Surgery, Scott and White Hospital, Temple, Tex (Dr Matheny).

Footnotes
Accepted for publication Jan 25, 1985.

Read before the 92nd annual meeting of the Western Surgical Association, Colorado Springs, Colo, Nov 14, 1984.

Reprint requests to St Luke's Episcopal Hospital, PO Box 20269, Houston, TX 77225 (Dr Dudrick).

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