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Eisen

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Transfusionsassoziierte Pharmakotherapie

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Zusammenfassung

Eisen ist ein essentielles Spurenelement, wichtig vor allem für die Hämoglobinsynthese. Eisenmangel mit und ohne Anämie stellt perioperativ einen Risikofaktor für Morbidität und Mortalität dar und sollte vor elektiven Operationen diagnostiziert und behandelt werden. Eisensubstitution ist wirksamer vor als nach einer Operation, weil die postoperative Zytokinausschüttung den Erythropoietin- und Eisenstoffwechsel hemmen kann. Eine perioperative Eisensubstitution wird aktuell in vielen Studien untersucht, wobei die Datenlage bisher sehr heterogen ist und wenig signifikante Aussagen zulässt. Orale Eisentherapie ist nur bei akutem Eisenmangel oder begleitend bei der Eigenblutgewinnung vor der OP gut wirksam. Postoperativ ist die Eisenabsorption einige Zeit gehemmt und eine Eisensubstitution wenig effektiv. Eine intravenöse Eisensubstitution in hoher Dosierung (1000 mg – mit und ohne rHuEPO) sollte mit besonderer Sorgfalt eingesetzt werden (sehr selten anaphylaktische Reaktionen).

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  1. Leiter der Eisenstoffwechselambulanz UKE Hamburg, Martinistraße 52, 20246, Hamburg, Deutschland

    Priv.-Doz. Dr. med. Dr. rer. nat. Peter Nielsen

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    Günter Singbartl

  2. Department of Anesthesiology, Milton S. Hershey Medical Center, Hershey, USA

    Kai Singbartl

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Nielsen, P. (2016). Eisen. In: Singbartl, G., Singbartl, K. (eds) Transfusionsassoziierte Pharmakotherapie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-47258-3_1

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