Effect of Intravenous Ferric Carboxymaltose on Hemoglobin Response Among Patients With Acute Isovolemic Anemia Following Gastrectomy

Kim, Young Woo; Bae, Jae Moon; Park, Young Kyu; Yang, Han Kwang; Yu, Wansik; Yook, Jeong Hwan; Noh, Sung Hoon; Han, Mira; Ryu, Keun Won; Sohn, Tae Sung; Lee, Hyuk Joon; Kwon, Oh Kyoung; Ryu, Seunghyong; Lee, Jun Ho; Kim, Sung Hoon; Yoon, Hong Man; Choi, Min Gew; Jeong, Oh; Suh, Yun Suhk; Kim, Beom Su; Jung, Mi Ran; An, Ji Yeong; Kim, Wook; Kim, Young-Sook; Yang, Hannah; Nam, Byung Ho

doi:10.1001/jama.2017.5703

Cited by 75 publications

(114 citation statements)

References 21 publications

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“…Iron supplementation should be considered in patients with iron deficiency or significant reduction in postoperative haemoglobin, starting early in the postoperative recovery phase where there are no major complications . It is important to note that there are no studies identifying the best time to start postoperative iron supplementation.…”

Section: When Should Postoperative Anaemia Be Treated?mentioning

confidence: 99%

An international consensus statement on the management of postoperative anaemia after major surgical procedures

Múñoz

Acheson

Bisbe³

et al. 2018

Anaesthesia

166

153

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Despite numerous guidelines on the management of anaemia in surgical patients, there is no pragmatic guidance for the diagnosis and management of anaemia and iron deficiency in the postoperative period. A number of experienced researchers and clinicians took part in a two-day expert workshop and developed the following consensus statement. After presentation of our own research data and local policies and procedures, appropriate relevant literature was reviewed and discussed. We developed a series of best-practice and evidence-based statements to advise on patient care with respect to anaemia and iron deficiency in the postoperative period. These statements include: a diagnostic approach to iron deficiency and anaemia in surgical patients; identification of patients appropriate for treatment; and advice on practical management and follow-up that is easy to implement. Available data allow the fulfilment of the requirements of Pillar 1 of Patient Blood Management. We urge national and international research funding bodies to take note of these recommendations, particularly in terms of funding large-scale prospective, randomised clinical trials that can most effectively address the important clinical questions and this clearly unmet medical need.

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Section: When Should Postoperative Anaemia Be Treated?mentioning

confidence: 99%

An international consensus statement on the management of postoperative anaemia after major surgical procedures

Múñoz

Acheson

Bisbe³

et al. 2018

Anaesthesia

166

153

View full text Add to dashboard Cite

show abstract

“…Severe IDA will recur unless the underlying cause is identified and addressed when possible. After stability has been achieved with RBCT, additional pharmacological treatment should be considered (e.g., intravenous iron, rHuEPO) [14, 60, 61]. …”

Section: Treatment Options For Iron Deficiencymentioning

confidence: 99%

Management of Perioperative Iron Deficiency Anemia

et al. 2019

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Preoperative anemia affects 30–40% of patients undergoing major surgery and is an independent risk factor for perioperative blood transfusion, morbidity, and mortality. Absolute or functional iron deficiency is its leading cause. Nonanemic hematinic deficiencies are also prevalent and may hamper preoperative hemoglobin optimization and/or recovery from postoperative anemia. As modifiable risk factors, anemia and hematinic deficiencies should be detected and corrected prior to major surgical procedures. Postoperative anemia is even more common (up to 80–90%) due to surgery-associated blood loss, inflammation-induced blunted erythropoiesis, and/or preexisting anemia. Preoperative oral iron may have a role in mild-to-moderate anemia, provided there is sufficient time (6–8 weeks) and adequate tolerance of oral preparations. Postoperative oral iron is of little value and rife with gastrointestinal adverse events. Intravenous iron should preferentially be used in cases of moderate-to-severe iron deficiency anemia, concomitant use of erythropoiesis-stimulating agents, short time to surgery or nonelective procedures, and for postoperative anemia management. Minor infusion reactions to intravenous iron are rare, the incidence of severe anaphylactic reactions is extremely low, and there is no increase in infections with intravenous iron. Currently available intravenous iron formulations allowing administration of large single doses are preferred.

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“…10 In addition, the use of IV iron in patients with gastric cancer also has produced good results in terms of haemoglobin elevation. 11,12 Use of high-dose iron supplements for treating preoperative anaemia holds clinical significance in operations that are performed according to a set schedule, such as gastric surgery. In this study, one patient in the JW group received an intravenous infusion of 500 mg ferric carboxymaltose on the 3rd day after total gastrectomy.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic D1+ Lymph Node Dissection for Gastric Cancer in Jehovah's Witness Patients: a 1:3 Matched Case Control Study

Lee

Kim

Park

2017

J Minim Invasive Surg

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Purpose: Laparoscopic gastrectomy in early gastric cancer patients is accepted as standard, but it is sometimes challenging for patients who refuse blood transfusions such as Jehovah's Witness (JW) patients, because of the risk of bleeding related to radical lymph node dissection. This study aimed to confirm the adequacy and safety of laparoscopic gastrectomy with D1+ lymphadenectomy in JW patients. Methods:From January 2009 to December 2015, 265 gastric cancer patients underwent laparoscopic gastrectomy in our institute. Among them, there were 25 JW, and they were statistically matched with 75 patients from the control groups depending on age, sex, and body mass index (BMI). In a retrospective review, patient laboratory values and their pathology results were analysed.Results: There was no significant difference when comparing the clinical characteristics of JW and control groups. There was no statistically significant difference in blood loss or operation time between the two groups. Mean blood loss was 202.4±172.6 ml in the JW group and 179.7±163.8 ml in the control group (p=0.556). The number of retrieved lymph nodes was 27.8±13.9 in the JW group and 29.3±12.1 in the control group (p=0.607). Haemoglobin and haematocrit were measured after surgery and there was no statistically significant difference between the two groups. Conclusion:Laparoscopic D1+ gastrectomy in a JW may be performed with an equivalent risk to the control group. Laparoscopic gastrectomy can be applied to Jehovah's Witnesses if the specialied cancer center has sufficient experience in stomach cancer surgery, even if there is not enough experience in bloodless surgery.

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Effect of Intravenous Ferric Carboxymaltose on Hemoglobin Response Among Patients With Acute Isovolemic Anemia Following Gastrectomy

Abstract: clinicaltrials.gov Identifier: NCT01725789.

Cited by 75 publications

References 21 publications

An international consensus statement on the management of postoperative anaemia after major surgical procedures

An international consensus statement on the management of postoperative anaemia after major surgical procedures

Management of Perioperative Iron Deficiency Anemia

Laparoscopic D1+ Lymph Node Dissection for Gastric Cancer in Jehovah's Witness Patients: a 1:3 Matched Case Control Study

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