Utilization trends and safety of intravenous iron replacement in pediatric specialty care: A large retrospective cohort study

Boucher, Alexander A.; Pfeiffer, Amanda; Bedel, Ashley; Young, John P.; McGann, Patrick T.

doi:10.1002/pbc.26995

Cited by 27 publications

(32 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this issue of the journal, Boucher et al. describe the experience of the Cincinnati Children's Hospital Medical Center from January 2010 through October 2016 with the use of iron sucrose, ferric gluconate, and low molecular weight iron dextran (LMWID) in children with IDA due to a variety of underlying gastrointestinal, hematologic, gynecological, and other indications . A total of 1,088 doses of intravenous iron were administered to 194 patients without any serious infusion‐related or anaphylactic reactions.…”

mentioning

confidence: 99%

“…In the study of Boucher et al., a majority of patients (68%) required multiple infusions . This is the result of using mainly iron sucrose and ferric gluconate (in 1,077 of the described 1,088 infusions); these are second generation intravenous iron products that cannot be used for total dose infusion (TDI) or correction of the total estimated patients’ iron deficit at a single setting.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Intravenous iron: Safe and underutilized in children

Mantadakis

2018

Pediatric Blood & Cancer

View full text Add to dashboard Cite

show abstract

mentioning

confidence: 99%

mentioning

confidence: 99%

Intravenous iron: Safe and underutilized in children

Mantadakis

2018

Pediatric Blood & Cancer

View full text Add to dashboard Cite

show abstract

“…Preoperative anemia is prevalent with ~40% incidence in children worldwide and a 15%‐20% prevalence in children in industrialized countries; 1% having severe anemia. The main etiology is iron deficiency . The impact of preoperative anemia on postoperative patient outcomes has been reported.…”

Section: Standard 13 Guidence Patient Blood Management For Pediatricmentioning

confidence: 99%

“…The main etiology is iron deficiency. 3,24,29 The impact of preoperative anemia on postoperative patient outcomes has been reported. Preoperative anemia is independently associated with increasing the risk of requiring a blood transfusion and increasing postoperative morbidity and mortality in surgical and critically ill pediatric patients.…”

mentioning

confidence: 99%

Society for the advancement of blood management administrative and clinical standards for patient blood management programs. 4th edition (pediatric version)

Goobie¹,

Gallagher²,

Gross

et al. 2019

Pediatric Anesthesia

View full text Add to dashboard Cite

Summary Patient Blood Management is the timely application of evidence‐based medical and surgical concepts designed to maintain hemoglobin concentration, optimize hemostasis, and minimize blood loss to improve patient outcomes. Conceptually similar to a “bundle” strategy, it is designed to improve clinical care using comprehensive evidence‐based treatment strategies to manage patients with potential or ongoing critical bleeding, bleeding diathesis, critical anemia, and/ or a coagulopathy. Patient Blood Management includes multimodal strategies to screen, diagnose and properly treat anemia, coagulopathies and minimize bleeding, using goal‐directed therapy and leverages a patient's physiologic ability to adapt to anemia while definitive treatment is undertaken. Allogeneic blood component transfusion is one traditional therapeutic modality out of many for managing blood loss and anemia and, while it may be the best choice in certain situations, other effective and more appropriate options are available and should be used in conjunction or alone. Therefore, comprehensive Patient Blood Management is the new standard of care to prevent and manage anemia and optimize hemostasis and has been recommended by the World Health Organization, the American Society of Anesthesiologists, the European Society of Anaesthesiology and the Australian National Blood Authority. While there is a plethora of expert consensus and good practice guidelines published for blood component transfusion from multiple professional organizations and societies, there remains a need for more comprehensive and broader standards of patient medical management to proactively reduce the risk of exposure to allogeneic transfusions. In 2010, the Society for Advancement of Blood Management published the first comprehensive standards to address the administrative and clinical components of an effective, patient‐centered Patient Blood Management program. Recognizing the need to reduce inappropriate transfusions, some professional organizations have placed their emphasis on transfusion guidelines. In contrast, the focus of the Society for Advancement of Blood Management Standard is on the centrality of the patient and the full spectrum of therapeutic strategies needed to improve clinical outcomes in patients at risk for blood loss or anemia, thereby reducing avoidable transfusions as well. The Standards are meant not to replace, but to complement transfusion guidelines by more completely addressing the need for a multi‐modal clinical approach with the goal to improve patient outcomes. Compared to adult programs, Pediatric Patient Blood Management programs are currently not commonly accepted as standard of care for pediatric patients. This is partly due to the fact that, until recently, there was a paucity of robust evidence‐based literature and expert consensus guidelines on pediatric PBM. Managing pediatric bleeding and blood product transfusion presents a unique set of challenges. The main goal of transfusion is to correct or avoid imminent inadequate oxygen c...

show abstract

“…Anaphylaxis is rare, though “pseudo‐allergic” reactions as a result of free iron release into the plasma are difficult to distinguish from the former. Despite the very low risk of serious adverse effects, administration should be performed at centers with trained staff to provide appropriate care in the event of an adverse reaction…”

Section: Introductionmentioning

confidence: 99%

How I approach iron deficiency with and without anemia

Powers

O’Brien

2018

Pediatric Blood & Cancer

View full text Add to dashboard Cite

Iron deficiency anemia remains a common referral to the pediatric hematology–oncology subspecialist. Improved understanding of iron homeostasis, including the effects of the regulatory hormone hepcidin, recent adult and pediatric clinical trial data, as well as the availability of safer formulations of intravenous iron, have resulted in additional considerations when making treatment recommendations in such patients. Young children and adolescent females remain the most commonly affected groups, but children with complex medical or chronic inflammatory conditions including comorbid gastrointestinal disorders also require special consideration.

show abstract

Utilization trends and safety of intravenous iron replacement in pediatric specialty care: A large retrospective cohort study

Cited by 27 publications

References 25 publications

Intravenous iron: Safe and underutilized in children

Intravenous iron: Safe and underutilized in children

Society for the advancement of blood management administrative and clinical standards for patient blood management programs. 4th edition (pediatric version)

How I approach iron deficiency with and without anemia

Contact Info

Product

Resources

About