Why iv iron infusions

A shortage of iron in the diet can lead to iron deficiency anemia and other…. The uses and benefits of iron infusion. Medically reviewed by Alana Biggers, M. Who needs an iron infusion? What to expect What happens after an iron infusion? Iron infusion vs. Share on Pinterest A diet low in iron may lead to low iron supplies in the blood. What to expect. What happens after an iron infusion? Share on Pinterest Side effects of an iron infusion may include headaches and joint pain.

Share on Pinterest An iron infusion may be delivered intravenously. Risks and benefits. Scientists identify new cause of vascular injury in type 2 diabetes. Adolescent depression: Could school screening help? Related Coverage. Can an iron deficiency cause hair loss? All about autoimmune hemolytic anemia. What's to know about anemia rash? Medically reviewed by Suzanne Falck, MD. Macrocytic anemia: Symptoms and treatment. Medically reviewed by Elaine K. The findings of our study concur with the favorable outcomes reported by the other similar studies.

Iron deficiency ID is considered to be the leading cause in both men and women, albeit women are more commonly affected 1 , 2 , 3. The ID that leads to anemia could be of absolute or functional deficiency in nature. The absolute deficiency occurs due to the mismatch between iron uptake and utilization 1 and functional deficiency occurs due to the inflammation associated impaired iron release from enterocytes, macrophages and or hepatocytes 1 , 4 , 5.

Also, poor patient compliance due to side effects limits the efficacy of oral iron 1. However, being inexpensive and readily available, oral iron is still a viable option to start replacement in patients with mild anemia Hb, In contrast, IV iron leads to a faster replacement 1 , 6 , 7 , 8 , and diminishes the rate of recurrence of iron deficiency anemia in the long term 1 , 9 , Factors that are responsible for causing iron depletion are blood loss most common , poor nutrition, age, pregnancy, socioeconomic status and or various pathological conditions Additionally, many individuals may develop ID in response to therapies such as nonsteroidal anti-inflammatory medications Regardless of whether the ID or iron deficiency anemia IDA develops due to a disease process and or therapy, it is a cause of concern in patients who undergo surgery because it adversely impacts the prognosis Along with preoperative anemia, ABT and significant perioperative blood loss have also been associated with negative clinical outcomes 14 , Administration of allogenic blood to perioperative anemic patients is associated with increased rates of infections, cardiac complications, prolonged hospital stays and more deaths 14 , 17 , 19 , 20 , Nonetheless, despite the existing evidence of how even small amounts of transfused allogenic blood impacts morbidity and mortality negatively, anemia correction by ABT is still quite prevalent 14 , Although patient blood management PBM programs have been successfully developed and implemented in some countries 14 , 23 , 24 , most countries still lack them and thus persisting evidence gaps and skepticism give rise to varying ABT practices among the clinicians 14 , One of the objectives of PBM is correction of anemia before surgery, especially before major surgical procedures 14 , 18 , 25 , ID assessment should ideally be done 4 weeks prior to a major surgery to allow correction of reversible hemopoietic deficiencies 14 , 26 , 27 , For the correction of ID or IDA, both IV and oral iron are considered effective 14 , 29 , 30 , but only oral iron therapy has managed to become standard practice 14 , 30 , However, existing evidence suggests that the treatment with IV iron in elective surgeries and urgent cases benefits patients and minimizes ABT and its associated adverse events 14 , 26 , The mounting evidence supporting the predicted positive effect of IV iron on iron levels in the immediate postoperative period and subsequent weeks after hospital discharge would encourage the widespread use of IV iron e.

The objective of the study was to conduct retrospective analyses of the medical records of preoperative IDA patients who were hospitalized for surgeries between Jan and Dec Out of 10, patients, patients had anemia and were divided into 3 groups to compare the data pertinent to the perioperative management of anemia. We also explored the presence of hypophosphatemia that may have occurred as a side effect of IV FCM administration. Prior to the commencement of the study, ethics approval and written consent was obtained from all the relevant persons or authorities.

This manuscript has not been published and or submitted for consideration for publication elsewhere. Approved by all of our authors who have no conflicts of interest to disclose, I am submitting this manuscript to your journal. All the steps of the study were conducted in accordance with the above guidelines, conforming to the standard operational procedures for clinical studies approved for Sp Judetean, Timis Emergency County Hospital, Romania.

This retrospective study was conducted in our University hospital and as a part of routine procedure informed written consent forms stating that the data can be used for future medical research purpose were signed by each patient at the time of admission in the hospital. The data analyses of the surgical records of 10, patients from and from who underwent surgery yielded the following results: of the 10, The analysis showed that the IV iron administration enhanced replacement of iron stores serum ferritin vs.

However, no differences in the discharge Hb levels, morbidity, mortality, and quality of life were noted. Despite the reported transfusion-associated higher costs and risks, it is by far the default treatment for IDA in the perioperative period 14 , 33 , 34 , Our study demonstrates IV iron as a viable alternative to reduce ABT and its associated costs and risks in managing perioperative anemia.

This benefit of perioperative administration of IV iron can be attributed to its ability to replenish iron stores required for erythropoiesis by the bone marrow, unlike ABT in which transfused RBCs are cleared from the circulation rapidly and have a shorter lifespan than normal RBCs 14 , Concurring with our finding, the significance of IV iron in reducing the proportion of transfused units of RBCs has been previously demonstrated in a clinical setting by Munoz 14 , Functional IDA is a common feature of most major surgeries.

Despite adequate iron stores in functional IDA, the unavailability of iron for erythropoiesis is due to the altered release of iron from macrophages and its subsequent incorporation into transferrin 38 , 39 , 40 , 41 , Results from various studies support the use of high dose IV iron infusion regimens to overcome this iron immobilization issue, wherein the iron saturated macrophages circumvent the hepcidin block by causing over-expression of ferroportin and the subsequent increase in transferrin saturation Therefore, preoperative IV iron administration can prevent postoperative anemia in patients with functional IDA 42 , Still, most often RBC transfusion is the strategy of choice to tackle perioperative IDA in the management of patients undergoing major surgeries, a finding that is also reported by Shin et al.

Supplementation with oral iron tends to be the first-line treatment for most IDA patients because of its low cost and easy availability. However, in conditions such as functional IDA and trauma or surgery, oral iron therapy is ineffective due to poor GI absorption and slow delivery and adverse effects, respectively.

As there is rapid and direct binding of IV iron to plasma transferrin, the erythropoietic effect increases about 5 times and lasts for 7—10 days 42 , The underlying mechanism that has been stated is based on the data from in vitro studies, which showed that approximately 45 mg of iron can be maintained in the plasma after the administration of mg IV iron, wherefrom the small proportion 4—5 mg and the large proportion is taken up by transferrin and macrophages, respectively IV iron formulations comprise an iron core and carbohydrate shell, the shell which steadies their release in the circulation Among the most commonly, reported adverse effects of IV iron are headache, vomiting, chest tightness, arthralgia, fever and hot flushes 42 , However, more serious adverse effects such as anaphylaxis, infection, oxidative stress, hypophosphatemia, hypotension, and even mortality have also been reported 42 , For instance, the use of high molecular weight iron dextran Dexferrum was discontinued due to its potential for causing anaphylaxis Also, no increase in mortality and adverse effects which required discontinuation were reported However, the common occurrence of IV iron associated infusion site reactions were reported 42 , Considering the safety profile low immunogenic potential and the single total dose infusion advantage of IV FCM 43 , plenty of data suggest the use of IV FCM for preoperative ID or IDA management, and therefore our county hospital also prefers its administration, if and when required.

FCM has a carboxymaltose outer shell, the shell which helps in sustained iron release and its optimal delivery to the tissues 32 , 42 , At our hospital, IV FCM is usually administered as a single infusion over 15 min, to a maximum weekly dose of up to mg European Union recommendation.

IV FCM is sufficient for replacing iron stores during the perioperative period 42 and the building evidence suggests that it may help minimize the need for ABTs during the perioperative period.

According to the most recent guidelines 24 , 42 , 50 , the preoperative patients with functional IDA who are at risk of excessive blood loss during surgery are recommended to get IVIT to improve outcomes The administration of IV FCM can substantially reduce the need for blood products in the management of preoperative anemia 24 , 51 , 52 and reduce the length of hospital stay 14 , Our results concur with the previous observational and experimental studies on the subject and thus contribute to the growing body of evidence in favor of perioperative IV iron e.

Therefore, studies are required to explore and highlight the economic benefits of IV iron in contrast to ABT and convince the regulatory authorities for the inclusion of IV iron e. FCM on the national insurance programs. Furthermore, implementing relevant protocols will also reduce transfusion related risks in IDA patients undergoing major surgeries.

Jimenez, K. Management of iron deficiency anemia. Google Scholar. Kassebaum, N. A systematic analysis of global anemia burden from to Blood 5 , — McLean, E. Worldwide prevalence of anaemia, WHO vitamin and mineral nutrition information system, — Public Health Nutr. Evstatiev, R. Iron sensing and signalling.

Gut 61 6 , — Weiss, G. Anemia of chronic disease. Khalafallah, A. A prospective randomized, controlled trial of intravenous versus oral iron for moderate iron deficiency anaemia of pregnancy.

Lindgren, S. The catheter is connected by a tube to an IV bag of iron. The iron in the bag is diluted with a saline solution. This iron solution is either pumped into the vein or uses gravity to drip down the tube into the body slowly. The doctor performing your iron infusion will first administer a test dose to ensure there are no adverse reactions. We treat many blood disorders including iron-deficiency anemia using infusions. Our facility offers an intimate setting where infusions are administered.

We know infusion therapy can seem scary at first, so we are here to make you as comfortable as possible. To learn more about our practice or to make an appointment, please contact us today. You can unsubscribe anytime. Our office is open during our normal business hours. To minimize possible exposure to our high-risk patients, please call our office at before your appointment. In Hematology , Infusion Center. Iron-deficiency anemia Anemia is the most common blood disorder, according to the National Heart, Lung, and Blood Institute, and affects more than 3 million Americans.

Treating iron-deficiency anemia Doctors sometimes prescribe oral medication to treat Iron-deficiency anemia, while others prefer their patients be treated intravenously IV , or through a vein.

When determining which iron therapy is right for you, oral or IV, it is essential to consider several factors, including: Age Intravenous iron infusions are used more commonly in adults — particularly in adults with ongoing bleeding or after gastric bypass surgery, a procedure that makes it more difficult to absorb iron. Cost Oral iron is less expensive, readily available over the counter and may be the only choice for some anemia patients. Absorption Many people who opt for IV iron are unable to absorb iron orally.

These side effects can include: Nausea Constipation Stomach pain Vomiting The liquid form of oral iron also has a metallic taste and can stain teeth. Length of treatment Oral iron can often take months to counteract anemia entirely and even longer to restore iron in the body to normal levels.