Research Article

Determination of Allogeneic Transfusion after Injection of Injectable Iron in Patient's Candidates for Intertrochanteric Fracture Surgery

Abstract

Background: The purpose of this study is to investigate the rate of allogeneic transfusion after the administration of intravenous iron in patients who are candidates for intertrochanteric fracture surgery.
Methods: Patients who were candidates for intertrochanteric surgery referred to the orthopedic surgery and trauma department of Shahada Tajrish Hospital were included in the study after providing full explanations and obtaining written consent. The 80 patients were randomly divided into control group (No: 40) and intervention (No: 40). Patients in the intervention group were prescribed 600 mg of Venofer drug by ViforCo. This is while patients in the control group were not injected with Venofer before surgery. The results were evaluated using t-test and SPSS21 software.
Results: Based on the results, the 1 hour after surgery, three indicators of systolic blood pressure, pulse rate, breathing rate, RBC showed a significant decrease in patients undergoing intervention (P<0.05). However, the oxygenation index showed a significant increase in the patients of this group (P>0.05). Meanwhile, in the period of 1 week after the surgery, we also see a significant decrease in the two indices of average hemoglobin and PTT time in the mentioned patients compared to the control subjects (P=0.030, P=0.037). The amount of blood consumed significantly lower in the patients of the intervention group than in the control group.
Conclusion: The administration of injectable iron in patients with intertrochanteric fracture surgery candidates can improve some of the patients' clinical indicators in addition to a significant reduction in allogeneic blood transfusion.

[1] Bisbe E, Basora M, Colomina MJ. Peri-operative treatment of anaemia in major orthopaedic surgery: a practical approach from Spain. Blood Transfus. 2017; 15(4):296–306.
[2] Gombotz H, Rehak PH, Shander A, Hofmann A. Blood use in elective surgery: the Austrian benchmark study. Transfusion. 2007; 47(8):1468–80.
[3] Goodnough LT. Iron deficiency syndromes and iron-restricted erythropoiesis (CME). Transfusion. 2012; 52(7):1584–92.
[4] Munoz M, Laso-Morales MJ, Gomez-Ramirez S, Cadellas M, Nunez-Matas MJ, Garcia-Erce JA. Pre-operative haemoglobin levels and iron status in a large multicentre cohort of patients undergoing major elective surgery. Anaesthesia. 2017; 72(7):826-834.
[5] Goodnough LT, Nemeth E, Ganz T. Detection, evaluation, and management of iron-restricted erythropoiesis. Blood. 2010; 116(23):4754–61.
[6] Hill GE, Frawley WH, Griffith KE, Forestner JE, Minei JP. Allogeneic blood transfusion increases the risk of postoperative bacterial infection: a meta-analysis. J Trauma. 2003; 54(5):908–14.
[7] Munoz M, Breymann C, Garcia-Erce JA, Gomez-Ramirez S, Comin J, Bisbe E. Efficacy and safety of intravenous iron therapy as an alternative/adjunct to allogeneic blood transfusion. Vox Sang. 2008; 94(3):172–83.
[8] Munoz M, Garcia-Erce JA, Villar I, Thomas D. Blood conservation strategies in major orthopaedic surgery: efficacy, safety and European regulations. Vox Sang. 2009; 96(1):1–13.
[9] Mundy GM, Birtwistle SJ, Power RA. The effect of iron supplementation on the level of haemoglobin after lower limb arthroplasty. J Bone Joint Surg Br. 2005; 87(2):213–7.
[10] Parker MJ. Iron supplementation for anemia after hip fracture surgery: a randomized trial of 300 patients. J Bone Joint Surg Am. 2010; 92(2):265–9.
[11] Litton E, Xiao J, Ho KM. Safety and efficacy of intravenous iron therapy in reducing requirement for allogeneic blood transfusion: systematic review and meta-analysis of randomised clinical trials. Bmj. 2013; 347:f4822.
[12] Auerbach M, Macdougall I. The available intravenous iron formulations: History, efficacy, and toxicology. Hemodial Int. 2017; 21 Suppl 1:S83–s92.
[13] Beris P, Munoz M, Garcia-Erce JA, Thomas D, Maniatis A, Van der Linden P. Perioperative anaemia management: consensus statement on the role of intravenous iron. Br J Anaesth. 2008; 100(5):599–604.
[14] Ionescu A, Sharma A, Kundnani NR, Mihăilescu A, David VL, Bedreag O, et al. Intravenous iron infusion as an alternative to minimize blood transfusion in peri-operative patients. Sci Rep. 2020; 10(1):18403.
[15] Muñoz M, Gómez-Ramírez S, Cuenca J, García-Erce JA, Iglesias-Aparicio D, Haman-Alcober S, et al. Very-short-term perioperative intravenous iron administration and postoperative outcome in major orthopedic surgery: a pooled analysis of observational data from 2547 patients. Transfusion. 2014; 54(2):289-99.
[16] Serrano-Trenas JA, Ugalde PF, Cabello LM, Chofles LC, Lázaro PS, Benítez PC. Role of perioperative intravenous iron therapy in elderly hip fracture patients: a single-center randomized controlled trial. Transfusion. 2011; 51(1):97-104.
[17] Cuenca J, García-Erce JA, Martínez F, Pérez-Serrano L, Herrera A, Muñoz M. Perioperative intravenous iron, with or without erythropoietin, plus restrictive transfusion protocol reduce the need for allogeneic blood after knee replacement surgery. Transfusion. 2006; 46(7):1112-9.
[18] Bisbe E, Rodríguez C, Ruiz A, Sáez M, Castillo J, Santiveri X. Uso preoperatorio de hierro endovenoso, una nueva terapéutica en medicina transfusional [Preoperative use of intravenous iron: a new transfusional therapy]. Rev Esp Anestesiol Reanim. 2005; 52(9):536-40.
[19] Cuenca J, García-Erce JA, Muñoz M, Izuel M, Martínez AA, Herrera A. Patients with pertrochanteric hip fracture may benefit from preoperative intravenous iron therapy: a pilot study. Transfusion. 2004; 44(10):1447-52.
Files
IssueArticle in Press QRcode
SectionResearch Article(s)
Keywords
Allogeneic transfusion Intertrochanteric fracture Iron

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Behnaz F, Mohammadzadeh Namaghi R, Mohseni G, Jafari Kafiabadi M. Determination of Allogeneic Transfusion after Injection of Injectable Iron in Patient’s Candidates for Intertrochanteric Fracture Surgery. Arch Anesth & Crit Care. 2024;.