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Hulin S, Durandy Y.
Ann Fr Anesth Reanim. 2005 Jul 7; [Epub ahead of print]
Objective
Anaemia is the main complication following haemodilution in paediatric cardiac surgery. Iron oral therapy is ineffective to improve anaemia. The aim of this study is to assess the effect of a single dose of intravenous iron saccharate Venofer((R)).
Study design
Open, randomized.
93 patients were randomized in two groups. The first one is the control group without iron supplementation and the second one received a 5 mg/kg injection of Venofer((R)) administered at day 1. Three biological factors were studied on day 1 and day 5 following surgery: haemoglobin, ferrritin and reticulocyte rate. Student test was used for statistical analysis of results.
Results
Age, weight, haemoglobin, ferritine and reticulocyte on day 1 were similar in both group (no significant difference). On day 5 ferritin was higher in the treated group 215+/-87 vs 101+/-55 mug/l in the non treated group (P<0.001). Reticulocyte rate was also higher in the treated group 3.25+/-1.16 vs 2.65+/-0.97% (P<0.005) in the untreated group.
Conclusion
Postoperative systemic inflammation is probably the factor which impaired the effect of oral iron therapy. Parenteral iron may act by treating a functional iron deficiency and/or by increasing endogenous erythropoietin synthesis. Faster reversibility of anaemia following iron injection improves quality of the postoperative recovery.