Monday, 30 September 2013

Article worth looking at ...

Safety and efficacy of Intravenous iron therapy in reducing requirement for allogenic blood transfusion : systematic review and meta-analysis of randomized clinical trials . BMJ  August 2013

The use of intravenous iron to treat anaemia and hence reduce the need for blood transfusions is becoming more popular. It is now recommended by the National Blood Authority in their Patient Blood Management Guidelines as a part of preoperative haemoglobin optimisation.
This meta-analysis looks at over 10 000 patients who were involved in randomized controlled trials of intravenous iron compared with either no iron or oral iron. They found that intravenous iron increases the haemoglobin concentration (standardized mean difference 6.5g/L, 5.1 – 7.9) and reduces the need for blood transfusions (risk ratio 0.74, 0.62 – 0.88). They also found however that the risk of infection was increased (RR 1.33, 1.1-1.64).
So, IV iron is good to reduce the need for transfusion but may result in more infections. We need a well powered RCT looking at the end points of infection, morbidity and mortality to work out the role of iron transfusion as a therapy to reduce the need for tranfusions.

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