Intravenous iron administration before cardiac surgery reduces red blood cell transfusion in patients without anaemia.

Humans Administration, Intravenous Anemia / drug therapy Cardiac Surgical Procedures Erythrocyte Transfusion Ferric Compounds / therapeutic use Hemoglobins / analysis Iron / therapeutic use Maltose / therapeutic use Double-Blind Method
anaemia cardiac surgery ferric carboxymaltose iron red cell transfusion

Journal

British journal of anaesthesia
ISSN: 1471-6771
Titre abrégé: Br J Anaesth
Pays: England
ID NLM: 0372541

Informations de publication

Date de publication:
12 2023
Historique:
received: 15 05 2023
revised: 02 09 2023
accepted: 14 09 2023
medline: 15 11 2023
pubmed: 15 10 2023
entrez: 14 10 2023
Statut: ppublish

Résumé

Reducing the need for blood transfusion among patients undergoing cardiac surgery FLA reduce postoperative complications and mortality. Our study aimed to assess the effects of administering preoperative i.v. ferric carboxymaltose on postoperative red cell transfusion requirements in patients without anaemia undergoing on-pump cardiac surgery. This double-blind, randomised, placebo-controlled trial was conducted between October 2016 and November 2019, with a follow-up period of up to 6 weeks after surgery. Patients without anaemia who underwent on-pump cardiac surgery were included as participants and administered i.v. iron in the form of ferric carboxymaltose or placebo once, 24-72 h before surgery. The primary outcome was the number of red cell units transfused during the first four postoperative days, and the secondary outcome measures were blood haemoglobin concentrations at 4 days and 6 weeks after surgery. The 200 patients included were randomly assigned to the ferric carboxymaltose (n=102) and placebo (n=98) groups. By postoperative Day 4, a significantly lower mean number of red cell units were transfused in the ferric carboxymaltose than in the placebo group, 0.3 (0.8) vs 1.6 (4.4), respectively; P=0.007. The mean haemoglobin concentrations on postoperative Day 4 were 9.7 (1) g dl In patients without anaemia undergoing on-pump cardiac surgery, treatment with a single dose of 1000 mg ferric carboxymaltose i.v. 1-3 days before surgery significantly reduced the need for red cell transfusions and increased the postoperative haemoglobin concentration. NCT02939794.

Sections du résumé

BACKGROUND
Reducing the need for blood transfusion among patients undergoing cardiac surgery FLA reduce postoperative complications and mortality. Our study aimed to assess the effects of administering preoperative i.v. ferric carboxymaltose on postoperative red cell transfusion requirements in patients without anaemia undergoing on-pump cardiac surgery.
METHODS
This double-blind, randomised, placebo-controlled trial was conducted between October 2016 and November 2019, with a follow-up period of up to 6 weeks after surgery. Patients without anaemia who underwent on-pump cardiac surgery were included as participants and administered i.v. iron in the form of ferric carboxymaltose or placebo once, 24-72 h before surgery. The primary outcome was the number of red cell units transfused during the first four postoperative days, and the secondary outcome measures were blood haemoglobin concentrations at 4 days and 6 weeks after surgery.
RESULTS
The 200 patients included were randomly assigned to the ferric carboxymaltose (n=102) and placebo (n=98) groups. By postoperative Day 4, a significantly lower mean number of red cell units were transfused in the ferric carboxymaltose than in the placebo group, 0.3 (0.8) vs 1.6 (4.4), respectively; P=0.007. The mean haemoglobin concentrations on postoperative Day 4 were 9.7 (1) g dl
CONCLUSIONS
In patients without anaemia undergoing on-pump cardiac surgery, treatment with a single dose of 1000 mg ferric carboxymaltose i.v. 1-3 days before surgery significantly reduced the need for red cell transfusions and increased the postoperative haemoglobin concentration.
CLINICAL TRIAL REGISTRATION
NCT02939794.

Identifiants

DOI: 10.1016/j.bja.2023.09.007 PMID: 37838604
pubmed: 37838604
pii: S0007-0912(23)00503-2
doi: 10.1016/j.bja.2023.09.007
pii:
doi:

Substances chimiques

ferric carboxymaltose 6897GXD6OE
Ferric Compounds 0
Hemoglobins 0
Iron E1UOL152H7
Maltose 69-79-4
perferryl iron 14127-54-9

Banques de données

ClinicalTrials.gov
['NCT02939794']

Types de publication

Randomized Controlled Trial Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

981-988

Informations de copyright

Copyright © 2023 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

Auteurs

Tom Friedman (T)

Department of Cardiac Surgery, Rambam Health Care Campus, Haifa, Israel; Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel. Electronic address: tomalach@gmail.com.

Eldad J Dann (EJ)

Blood Bank and Apheresis Unit, Rambam Health Care Campus, Haifa, Israel; Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel; Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.

Keren Bitton-Worms (K)

Department of Cardiac Surgery, Rambam Health Care Campus, Haifa, Israel.

Maged Makhoul (M)

Department of Cardiac Surgery, Rambam Health Care Campus, Haifa, Israel.

Roi Glam (R)

Department of Cardiac Surgery, Rambam Health Care Campus, Haifa, Israel.

Anastasia Weis (A)

Department of Cardiac Surgery, Rambam Health Care Campus, Haifa, Israel.

Derrick Y Tam (DY)

Division of Cardiac Surgery, University of Toronto, Toronto, ON, Canada.

Gil Bolotin (G)

Department of Cardiac Surgery, Rambam Health Care Campus, Haifa, Israel; Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Intravenous iron administration before cardiac...
questionsmedicales.fr › Thérapeutique › Traitement médicamenteux › Voies d'administration de substances chimiques et des médicaments › Administration par voie intraveineuse › Intravenous iron administration before cardiac...
questionsmedicales.fr › Hémopathies et maladies lymphatiques › Hémopathies › Anémie › Intravenous iron administration before cardiac...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie thoracique › Procédures de chirurgie cardiaque › Intravenous iron administration before cardiac...
questionsmedicales.fr › Thérapeutique › Biothérapie › Transfusion sanguine › Transfusion de composants du sang › Transfusion d'érythrocytes › Intravenous iron administration before cardiac...
questionsmedicales.fr › Produits chimiques inorganiques › Composés du fer › Composés du fer III › Intravenous iron administration before cardiac...
questionsmedicales.fr › Acides aminés, peptides et protéines › Protéines › Hémoprotéines › Globines › Hémoglobines › Intravenous iron administration before cardiac...
questionsmedicales.fr › Produits chimiques inorganiques › Métaux › Métaux lourds › Fer › Intravenous iron administration before cardiac...
questionsmedicales.fr › Glucides › Sucres › Diholoside › Maltose › Intravenous iron administration before cardiac...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Méthodologie en recherche épidémiologique › Méthode en double aveugle › Intravenous iron administration before cardiac...