Perioperative stimulation of erythropoiesis with intravenous iron and erythropoietin reduces transfusion requirements in patients with hip fracture. A prospective observational study

García‐Erce, José Antonio; Cuenca, Jorge; Múñoz, Manuel; Izuel, M.; Martı́nez, Amalia; Herrera, Antonio; Solano, Víctor Manuel; Martínez, Fernando

doi:10.1111/j.1423-0410.2005.00627.x

Cited by 97 publications

(115 citation statements)

References 39 publications

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“…A review of the evidence based outcomes of the different supplementations in hip and knee surgery suggested that iron therapy, both oral and intravenous have been shown to reduce the need for allogeneic blood transfusion and significantly reduced the post-operative infection rate [28][29][30][31]. In our hand, IV iron was superior to oral iron and both have improved the preoperative Hb, nevertheless, with a greater and significant effect in the IV iron group.…”

Section: Discussionmentioning

confidence: 57%

“…A systemic review comparing the evidence of administering erythropoietin with iron supplements to an active control group of either iron supplementation or cell salvage [26,30], showed that the clinical outcomes of post-operative infections, length of stay and 30 day mortality were generally not significant when compared to the active control group in these studies.…”

Section: Discussionmentioning

confidence: 99%

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A Prospective Randomized Controlled Trial to Assess the Effect of Intravenous versus Oral Iron Therapy in the Treatment of Preoperative Anaemia

Khalafallah¹,

Al-Barzan²,

Chan³

et al. 2012

J Blood Disord Transfus

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Background: Improving preoperative anaemia is associated with a better surgical outcome. There is lack of data regarding treatment of preoperative anaemia with intravenous versus oral iron.Objective: Assessment of efficacy of oral iron sulphate versus a single intravenous iron polymaltose and subsequent effect on perceived quality of life in both treatment groups. Patients and methods:We conducted a prospective randomised controlled trial with iron therapy for the treatment of Iron Deficiency Anaemia (IDA) patients who were undergoing elective joint arthroplasty. At a single institution, we recruited 44 patients who were randomized to a single intravenous iron polymaltose infusion (16/22) versus oral daily iron sulphate (17/22). Median age was 68 years (range, 45-91) with a male to female ratio of 14:19.

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

A Prospective Randomized Controlled Trial to Assess the Effect of Intravenous versus Oral Iron Therapy in the Treatment of Preoperative Anaemia

Khalafallah¹,

Al-Barzan²,

Chan³

et al. 2012

J Blood Disord Transfus

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“…There was no difference in the 30 day mortality or the mean duration of hospitalization. 70 Previous recommendations that patients with preoperative anaemia due to iron deficiency or chronic disease may receive preoperative treatment with i.v. or oral iron, depending on the timing of surgery, the patient's tolerance of oral iron, and iron status, 71 72 are based on low-to-moderate-quality evidence.…”

Section: Patient Blood Managementmentioning

confidence: 99%

Patient Blood Management in Europe

Shander¹,

Aken²,

Gombotz³

et al. 2013

Survey of Anesthesiology

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“…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

“…La media de dosis de hierro recibida fue prácticamente idéntica que la que recibieron aquellos pacientes tratados únicamente con hierro iv y la dosis de rHuEPO fue de 2,4 inyecciones de 40.000 UI. La administración de hierro se ha utilizado también para mejorar la eficacia del tratamiento intravenoso con rHuEPO 23 . En un estudio que incluyó solo a 12 pacientes en los cuales se comparó la administración de 200 mg de hierro-sacarosa asociada a rHuEPO con la administración únicamente de hierro oral, Rohling et al 28 no observaron mejorías en la Hb preoperatoria.…”

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

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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.

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Perioperative stimulation of erythropoiesis with intravenous iron and erythropoietin reduces transfusion requirements in patients with hip fracture. A prospective observational study

Abstract: The blood-saving protocol implemented seems to reduce ABT requirements in patients with HF, and is associated with a lower postoperative morbidity. The possible mechanisms involved in these effects are discussed.

Cited by 97 publications

References 39 publications

A Prospective Randomized Controlled Trial to Assess the Effect of Intravenous versus Oral Iron Therapy in the Treatment of Preoperative Anaemia

A Prospective Randomized Controlled Trial to Assess the Effect of Intravenous versus Oral Iron Therapy in the Treatment of Preoperative Anaemia

Patient Blood Management in Europe

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

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