intravenous iron therapy | The Journal of Critical Care Medicine

The Importance of Iron Administration in Correcting Anaemia after Major Surgery

Mirela Tiglis^1,2, Cristian Cobilinschi^1,2, Liliana Elena Mirea^1,2, Alexandru Emil Băetu^1,2, Ileana Peride¹, Tiberiu Paul Neagu¹, Andrei Niculae¹, Ionel Alexandru Checherită¹, Ioana Marina Grintescu^1,2

1 “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
2 Emergency Clinical Hospital of Bucharest, Romania

DOI: 10.2478/jccm-2021-0028

Introduction: Postoperative anaemia can affect more than 90% of patients undergoing major surgeries. Patients develop an absolute iron deficiency in the face of significant blood loss or preoperative anaemia and major surgery. Studies have shown the negative impact of these factors on transfusion requirements, infections, increased hospitalisation and long-term morbidities.
Aim of the study: The research was performed to determine the correlation between intravenous iron administration in the postoperative period and improved haemoglobin correction trend.
Material and methods: A prospective study was conducted to screen and treat iron deficiency in patients undergoing major surgery associated with significant bleeding. For iron deficiency anaemia screening, in the postoperative period, the following bioumoral parameters were assessed: haemoglobin, serum iron, transferrin saturation (TSAT), and ferritin, direct serum total iron-binding capacity (dTIBC), mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH). In addition, serum glucose, fibrinogen, urea, creatinine and lactate values were also collected.
Results: Twenty-one patients undergoing major surgeries (52,38% were emergency and 47,61% elective interventions) were included in the study. Iron deficiency, as defined by ferritin 100-300 μg/L along with transferrin saturation (TSAT) < 20 %, mean corpuscular volume (MVC) < 92 fL, mean corpuscular haemoglobin (MCH) < 33 g/dL, serum iron < 10 μmol/L and direct serum total iron-binding capacity (dTIBC) > 36 μmol/L, was identified in all cases. To correct the deficit and optimise the haematological status, all patients received intravenous ferric carboxymaltose (500-1000 mg, single dose). Using Quadratic statistical analysis, the trend of haemoglobin correction was found to be a favourable one.
Conclusion: The administration of intravenous ferric carboxymaltose in the postoperative period showed the beneficial effect of this type of intervention on the haemoglobin correction trend in these groups of patients.