Patients with pertrochanteric hip fracture may benefit from preoperative intravenous iron therapy: a pilot study

Cuenca, Jorge; García-Erce, José Antonio; Múñoz, Manuel; Izuel, M.; Martı́nez, Amalia; Herrera, Antonio

doi:10.1111/j.1537-2995.2004.04088.x

Cited by 99 publications

(131 citation statements)

References 32 publications

Supporting

Mentioning

118

Contrasting

Unclassified

Order By: Relevance

“…iron can correct iron deficiency anaemia before elective orthopaedic surgery 67 and reduce rates of ABT, postoperative infection, and mortality in patients with hip fracture, compared with historical controls. 68 69 Another case series found that the perioperative use of i.v. iron in conjunction with ESA therapy in anaemic patients with hip fracture (Hb levels of ,13 g dl 21 ) reduced the proportion of patients requiring transfusion, the number of units transfused, and the rate of postoperative infections compared with a parallel control group.…”

Section: Patient Blood Managementmentioning

confidence: 99%

Patient Blood Management in Europe

Shander¹,

Aken²,

Gombotz³

et al. 2013

Survey of Anesthesiology

View full text Add to dashboard Cite

Section: Patient Blood Managementmentioning

confidence: 99%

Patient Blood Management in Europe

Shander¹,

Aken²,

Gombotz³

et al. 2013

Survey of Anesthesiology

View full text Add to dashboard Cite

“…26 No difference has been shown in blood transfusion rates (percentage of patients receiving a transfusion) in studies that compared patients receiving IV iron alone administered throughout the preoperative and postoperative periods with patients not receiving iron. [26][27][28] Conversely, a retrospective study focusing only on postoperative IV iron administration found that its use significantly reduced the percentage of patients receiving a transfusion (11.5% vs 26.4%, P = 0.001). 29 These findings are further complicated by subanalyses of 2 of the aforementioned trials showing that patients with preoperative hemoglobin concentrations greater than 12 g/dL required fewer transfusions compared with those in control groups.…”

Section: Perioperative Settingmentioning

confidence: 99%

“…No standard dose exists in this setting; however, total doses of 200 to 600 mg of iron sucrose (100-200 mg every 48 hours for 2-3 doses beginning on the day of admission) perioperatively have been reported in studies focusing on IV iron. [26][27][28][29][30][31] Studies typically did not report baseline iron labs; however, 1 trial specified that patients had nearnormal iron levels (46.3-53.2 µg/dL), with no significant difference between groups as well as normal ferritin and transferrin levels. 26 No difference has been shown in blood transfusion rates (percentage of patients receiving a transfusion) in studies that compared patients receiving IV iron alone administered throughout the preoperative and postoperative periods with patients not receiving iron.…”

Section: Perioperative Settingmentioning

confidence: 99%

Strategies for the Management of Postoperative Anemia in Elective Orthopedic Surgery

2016

View full text Add to dashboard Cite

Objective: To assess the use of oral iron, intravenous (IV) iron, and erythropoiesis-stimulating agents (ESAs) for the prevention and management of perioperative anemia in elective orthopedic surgery patients, and to provide a clinical algorithm for use. Data Sources: A PubMed and MEDLINE search was conducted from 1964 through March 2016 using the following search terms alone or in combination: orthopedic, surgery, elective, anemia, blood transfusion, iron, erythropoiesis-stimulating agents, and erythropoietin.Study Selection and Data Extraction: All English-language prospective and retrospective human studies and meta-analyses evaluating oral iron, IV iron, or ESA alone or in combination in elective orthopedic surgery patients were evaluated, provided they reported blood transfusion outcomes. Data Synthesis: A total of 9 prospective and retrospective studies and 1 meta-analysis were identified and included. In the preoperative setting, administration of oral iron, IV iron, or ESA alone or in combination to correct underlying anemia led to significantly reduced transfusion rates. Transfusion requirements were generally less with combination therapy (ESA + oral or IV iron). In the short-term perioperative or postoperative period, use of oral or IV iron led to conflicting results, with some reporting a statistically significant reduction in blood transfusions, whereas others reported none. Conclusions: In elective orthopedic surgery, IV or oral iron with or without an ESA may provide benefit in prevention of postoperative anemia and results in blood transfusion reduction without significantly increasing the risk of adverse events. These agents should be considered at the lowest effective dose with emphasis on administration prior to planned surgery.

show abstract

“…En cirugía, la experiencia se ha centrado con la corrección preoperatoria de la anemia por déficit de hierro debido a Optimización de la hemoglobina preoperatoria con hierro intravenoso 7 miomas 20 o neoplasia de colon 21 , o cirugía traumatológica y ortopédica 22,23 . En el campo de la cirugía ortopédica solo hay disponibles estudios observacionales con tamaños muestrales de 21 24 , 20 25 , y 21 26 pacientes.…”

Section: Discussionunclassified

Optimización de la hemoglobina preoperatoria en cirugía ortopédica mayor utilizando hierro intravenoso con o sin eritropoyetina. Estudio epidemiológico

Basora¹,

Tío²,

Mora

et al. 2015

Revista Española de Anestesiología y Reanimación

View full text Add to dashboard Cite

Cómo citar este artículo: Basora M, et al. Optimización de la hemoglobina preoperatoria en cirugía ortopédica mayor utilizando hierro intravenoso con o sin eritropoyetina. ResumenObjetivo: Evaluar la efectividad del tratamiento con hierro intravenoso, solo o asociado a eritropoyetina (rHuEPO), mediante el incremento de hemoglobina (Hb). Como objetivo secundario se analizó la relación del incremento de Hb con los parámetros utilizados para evaluar la anemia. Material y método: Estudio observacional retrospectivo realizado en 2 centros entre enero de 2005 y diciembre de 2009. Se incluyeron pacientes sometidos a cirugía ortopédica electiva con déficit de hierro y que fueron tratados con hierro sacarosa intravenosos solo o asociado a rHuEPO. Se analizó la efectividad del tratamiento mediante la diferencia entre la Hb basal y la Hb previa a la cirugía y se valoró la relación entre los parámetros hematimétricos y del metabolismo del hierro con la efectividad del tratamiento. Resultados: Se incluyeron 412 pacientes que recibieron una mediana de 800 mg de hierro sacarosa. A 125 pacientes (30,4%) se les asoció 2,4 viales de rHuEPO. El incremento de Hb fue de 0,8 (1,1) g/dL en los pacientes tratados con hierro intravenoso y de 1,5 (1,3) g/dL en los que se asoció rHuEPO (p < 0,01). El incremento de Hb en los pacientes tratados con hierro se correlacionó con el porcentaje de hematíes hipocromos (r = 0,52) y el valor del receptor soluble de la transferrina (r = 0,59). Results: A total of 412 patients who received a median of 800 mg of iron sucrose were included; 125 of them (30.4%) additionally received 2.4 vials of rHuEPO. The Hb increase was 0.8 (1.1) g/dL in patients treated with intravenous iron and 1.5 (1.3) g/dL in those additionally given rHuEPO(P < .01). The percentage of hypochromic red blood cells (r = 0.52) and soluble transferrin receptor (r = 0.59) value were significantly correlated to the Hb increase in patients receiving iron. Conclusions:In patients with iron deficiency anaemia, the effectiveness of iron sucrose treatment to optimize Hb before surgery was moderate; adjuvant administration of erythropoietin improved the results. Determination of functional iron status parameters may improve the treatment effectiveness.

show abstract

Patients with pertrochanteric hip fracture may benefit from preoperative intravenous iron therapy: a pilot study

Abstract: The administration of IV iron sucrose seems to reduce ABT requirements in patients with PHF and is associated to lower postoperative morbidity. The possible mechanisms involved in these effects are discussed.

Cited by 99 publications

References 32 publications

Patient Blood Management in Europe

Patient Blood Management in Europe

Strategies for the Management of Postoperative Anemia in Elective Orthopedic Surgery

Optimización de la hemoglobina preoperatoria en cirugía ortopédica mayor utilizando hierro intravenoso con o sin eritropoyetina. Estudio epidemiológico

Contact Info

Product

Resources

About