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In March 2007, the FDA issued a black-box warning for erythropoiesis-stimulating agents. It is recommended that the lowest possible dose be used to help patients avoid blood transfusions. Studies have shown increased mortality and/or a tumor progression in patients with cancer receiving an erythropoiesis-stimulating agent.
For more information, please review the FDA Fact Sheet available
online at: http://www.fda.gov/cder/drug/infopage/RHE/default.htm
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Anemia in Critically Ill Patients: Real-Life Experience and Treatment Strategies |
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Melissa Means-Markwell, MD, FACP, FACCP, and Patricia Wilson, BSN, RN
In this engaging discussion, Dr. Means-Markwell discusses the importance of considering the risks and benefits of transfusion in critically ill patients with anemia to select the most appropriate course of therapy.
 To take this course choose your format at the bottom of this page. 
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Supported by an educational grant from:
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| OVERVIEW |
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| Anemia is prevalent in the intensive care unit (ICU), affecting about 75% of critically ill patients, a third of whom are likely to receive blood transfusions. However, transfusions themselves pose a considerable risk of morbidity and mortality. Therefore, clinicians are encouraged to routinely screen their patients to identify those with risk factors for anemia and who meet appropriate transfusion triggers. The risks and benefits of transfusion and alternatives or adjunct therapies must be carefully weighed to select the most appropriate course of therapy. Joining us to discuss these issues and their practical applications are Melissa Means-Markwell, MD, FACP, FACCP, and Patricia Wilson, BSN, RN. |
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| OBJECTIVES |
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| Upon completion of this course, you should be able to: |
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Recognize the problem of anemia among critically ill patients, including its prevalence, pathophysiology, and risk factors
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Describe the potential risks and benefits of blood transfusions
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List pharmacologic options for the treatment of anemia
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| TARGET AUDIENCE |
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| This CME activity is designed for critical care physicians, critical care nurses, and other healthcare providers who treat patients with risk factors for anemia. |
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| FACULTY |
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| Melissa Means-Markwell, MD, FACP, FACCP
[BioSketch]
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| Assistant Professor of Medicine, Uniformed Services University of the Health Sciences; Intensivist, Suburban Hospital ICU, Bethesda, MD |
| Disclosure: No financial relationship with a commercial party to disclose. |
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| Patricia Wilson, BSN, RN
[BioSketch]
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| Assistant Nurse Manager,
Suburban Hospital ICU, Bethesda, MD
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| Disclosure: No financial relationship with a commercial party to disclose. |
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| CONFLICT OF INTEREST RESOLUTION |
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MEBN provides education approved by the AANP, AAPA, AARC, AAFP, CCMC and others, as well as being accredited to provide CME/CE by the ACCME, ACPE and ANCC through NHNA. Therefore, MEBN must ensure balance, independence, objectivity and scientific rigor in all of its educational activities. All faculty participating in these activities are expected to disclose any or no relevant financial interest or other relationship with (1) the manufacturer(s) of any commercial product(s) and/or provider(s) of commercial services discussed in any educational presentation, and/or (2) with any commercial supporters of an activity. Disclosure of any or no relationship(s) will be listed prior to any educational activity.
All apparent conflicts of interest have been identified and resolved through MEBN’s independent, peer-review process. Our intent is to assist learners in assessing the potential for bias in information that is presented during the educational activity. The faculty are also aware of their responsibility to inform the audience if discussion of any non-FDA-approved uses of pharmaceuticals, medical equipment, prostheses, etc. will be included in their presentation.
Unless otherwise indicated, MEBN staff and writers have no financial relationships with a commercial party to disclose. |
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| ACCREDITATION STATEMENT |
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| Continuing Medical Education for Physicians |
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| Accreditation Statement |
| MEBN is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. |
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| CME Credits |
| MEBN designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity. |
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| FDA Disclosure Statement |
| The contents of some CME activities may contain discussions of non-approved or off-label uses of some of the agents mentioned. Please consult the prescribing information for full disclosure of approved uses. |
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| Accreditation Period |
Original release date: March 23, 2006
Reviewed and Renewed: March 23, 2008
Expiration Date: March 23, 2009
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| Any questions regarding the accreditation of this CME activity should be directed to MEBN. (accreditation@mebn.net) | Continuing Education for Nurses MEBN is an approved provider of continuing nursing education by the New Hampshire Nurses’ Association Commission on Continuing Education, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. MEBN recognizes that the accredited status refers only to our continuing nursing education activities and does not imply that the ANCC Commission on Accreditation approves or endorses these commercial products.
Contact Hours MEBN designates this continuing education activity for up to 1 contact hour(s) of nursing continuing education credit.
Accreditation Period Original release date: March 23, 2006
Reviewed and Renewed: March 23, 2008
Expiration Date: March 23, 2009
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| DISCLAIMER |
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Disclaimer This continuing education program may
contain discussion of published and/or investigational uses of agents or
products that are not approved by the Food and Drug Administration (FDA). The
authors, sponsors or publishers do not recommend the use of any agent or product
outside of the official labeled indications. Please refer to the official
prescribing information for each agent or product for discussion of approved
indications, contraindications, and written warnings.
Any procedures, medications, or other courses of diagnosis or
treatment discussed or suggested in this course should not be used by clinicians
without evaluation of their patient's conditions and possible contraindications
on dangers in use, review of any applicable manufacturer's product information,
and comparison with recommendations of other authorities.
The authors, contributors, and editorial staff have made
every effort to contact holders of copyright to obtain permission to reproduce
copyright material. However, if any permissions have been inadvertently
overlooked, MEBN will be pleased to make the necessary and reasonable
arrangements. |
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| How to Take This Course |
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Choose Your Format To Begin Course: |
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| SUPPORTERS |
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Supported by an educational grant from: | |

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| CERTIFICATE FEES |
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| CME-TODAY offers FREE continuing medical education (CME) credits to recipients of the CD-ROM or CME-TODAY journal. Enter the CE Code listed on the CD-ROM or in the journal when prompted. This free offer expires on May 1, 2008. All others will be assessed a $10.00 processing fee. |
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