Iron supplementation in a case of severe iron deficiency anaemia

Füllenbach, Christoph; Triphaus, Chris; Glaser, Patricia; Ziebart, Alexander; Zacharowski, Kai; Meybohm, Patrick; Choorapoikayil, Suma

doi:10.1016/j.bja.2018.05.004

Cited by 6 publications

(4 citation statements)

References 9 publications

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“…Similarly, Füllenbach et al described a case report of a 73-year-old male patient with Hb of 4.5 g/dL and ferritin of 3 ng/mL. Iron supplementation nearly doubled Hb level within 3 weeks 22 . Kim et al observed a significant Hb increase of 2.6 g/dL within 3 weeks in anemic patients after gastrectomy treated with iv iron 23 .…”

Section: Discussionmentioning

confidence: 92%

“…supplementation nearly doubled Hb level within 3 weeks. 22 Kim et al observed a significant Hb increase of 2.6 g/dL within 3 weeks in anemic patients after gastrectomy treated with iv iron. 23 In these cases, but also in nontreated IDA patients undergoing surgery, blood transfusion would have reversed anemia only transiently, leaving the patient with empty iron stores and the recurrence of anemia eventually.…”

Section: Discussionmentioning

confidence: 98%

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Effectiveness of Preoperative Iron Supplementation in Major Surgical Patients With Iron Deficiency

et al. 2019

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Objective: To evaluate the effectiveness of routine intravenous iron in surgical patients with iron deficiency anemia (IDA). Background: Anemia is the most common medical disease in the world and is an independent risk factor for morbidity and mortality. Iron deficiency (ID) is the main cause for anemia and constitutes a potentially preventable condition with great impact on surgical outcome. Methods: In this prospective single-center observational study, surgical patients were screened for the presence of anemia and ID. Patients were assigned to 1 of 4 study groups:anemia, iron-deficient, iron supplementation) according to hemoglobin level, iron status, and supplementation with iron. Results: Among 1728 patients, 1028 were assigned to A), a reduced intraoperative transfusion rate was observed for ID and IDA patients only if iron was supplemented >7 days before surgery. Hospital stay was significantly reduced by 2.8 days in ironsupplemented patients (P < 0.01 comparing 13.9 AE 0.8 days for A þ , ID þ , T þ vs. 16.7 AE 0.7 days for A þ ). Conclusion: Preoperative IDA management with intravenous iron is effective in improving hemoglobin level, thereby reducing intraoperative RBC transfusion rate particular if iron is administrated >7 days before surgery. Hospital length of stay was reduced in all preoperatively iron-supplemented IDA patients.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 98%

Effectiveness of Preoperative Iron Supplementation in Major Surgical Patients With Iron Deficiency

et al. 2019

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“…iron, with haemoglobin increase to 8.7 g dl À1 and improvements in iron profile and overall health status in 3 weeks. 5 This case report serves to remind us all that iron deficiency anaemia is omnipresent, it can lower haemoglobin concentration (often single-handedly as seems to be the case here) to strikingly low concentrations, affecting quality of life. As demonstrated in this case, despite the low haemoglobin concentration, his anaemia was well managed without a single unit of blood, and blood transfusion does not need to be the default treatment, even in severe chronic cases.…”

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confidence: 55%

Intravenous iron for severe iron deficiency anaemia

Shander

Múñoz

Spahn

2018

British Journal of Anaesthesia

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“…As a result, the awareness of the effective role of iron supplementation to treat ID anaemic patients in the preoperative setting is increasing . For example, an increment in haemoglobin concentration of more than 2 g/dl can be accomplished with intravenous iron in severe anaemic ID patients . Transfusion with allogeneic blood products has been the first choice to treat anaemia for many decades.…”

Section: Discussionmentioning

confidence: 99%

Health economics of Patient Blood Management: a cost‐benefit analysis based on a meta‐analysis

et al. 2019

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Background and Objectives Patient Blood Management (PBM) is the timely application of evidence‐based medical and surgical concepts designed to improve haemoglobin concentration, optimize haemostasis and minimize blood loss in an effort to improve patient outcomes. The focus of this cost‐benefit analysis is to analyse the economic benefit of widespread implementation of a multimodal PBM programme. Materials and Methods Based on a recent meta‐analysis including 17 studies (>235 000 patients) comparing PBM with control care and data from the University Hospital Frankfurt, a cost‐benefit analysis was performed. Outcome data were red blood cell (RBC) transfusion rate, number of transfused RBC units, and length of hospital stay (LOS). Costs were considered for the following three PBM interventions as examples: anaemia management including therapy of iron deficiency, use of cell salvage and tranexamic acid. For sensitivity analysis, a Monte Carlo simulation was performed. Results Iron supplementation was applied in 3·1%, cell salvage in 65% and tranexamic acid in 89% of the PBM patients. In total, applying these three PBM interventions costs €129·04 per patient. However, PBM was associated with a reduction in transfusion rate, transfused RBC units per patient, and LOS which yielded to mean savings of €150·64 per patient. Thus, the overall benefit of PBM implementation was €21·60 per patient. In the Monte Carlo simulation, the cost savings on the outcome side exceeded the PBM costs in approximately 2/3 of all repetitions and the total benefit was €1 878 000 in 100·000 simulated patients. Conclusion Resources to implement a multimodal PBM concept optimizing patient care and safety can be cost‐effectively.

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Iron supplementation in a case of severe iron deficiency anaemia

Cited by 6 publications

References 9 publications

Effectiveness of Preoperative Iron Supplementation in Major Surgical Patients With Iron Deficiency

Effectiveness of Preoperative Iron Supplementation in Major Surgical Patients With Iron Deficiency

Intravenous iron for severe iron deficiency anaemia

Health economics of Patient Blood Management: a cost‐benefit analysis based on a meta‐analysis

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