Reply to Groome et al.

Abstract

We were glad to receive the comments from Groome et al.1Groome J. Anwar S. Ironing out some issues with Xu's paper on postoperative functional iron-deficiency anemia in cardiac valvular surgery patients (letter).J Cardiothorac Vasc Anesth. 2020; 34: 1112Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar regarding our recently published article.2Xu H. Duan Y. Yuan X. et al.Intravenous iron versus placebo in the management of postoperative functional iron deficiency anemia in patients undergoing cardiac valvular surgery: A prospective, single-blinded, randomized controlled trial.J Cardiothorac Vasc Anesth. 2019; 33: 2941-2948Abstract Full Text Full Text PDF PubMed Scopus (14) Google Scholar The primary effect of iron sucrose injection was to increase hemoglobin concentration, so we chose to define the primary endpoint event as hemoglobin changes on postoperative days 7 and 14. Although the length of hospital stay, mortality, and postoperative adverse events were influenced by many factors, changes in hemoglobin concentration had a relatively small influence on these adverse events, so there was no significant difference. In our trial, the treatment (intravenous iron) group and the control (placebo) group used the same level of monitoring, and we prepared cardiopulmonary resuscitation equipment and rescue drugs such as epinephrine, calcium gluconate, and atropine to deal with the adverse reactions. Our prior setting was the change in hemoglobin concentration, and the increments of hemoglobin >20 g/L also reflected the change in hemoglobin concentration. The increment of hemoglobin >20 g/L was taken as a comparison variable, mainly to reflect the changes of hemoglobin from different perspectives. We also are looking forward to the results of the Preoperative Intravenous Iron to Treat Anaemia in Major Surgery and Intravenous Iron for Treatment of Anaemia Before Cardiac Surgery trials, which also will guide the treatment of patients with anemia after surgery None. Ironing Out Some Issues With Xu's Article on Postoperative Functional Iron-Deficiency Anemia in Cardiac Valvular Surgery PatientsJournal of Cardiothoracic and Vascular AnesthesiaVol. 34Issue 4PreviewWe thank the Journal of Cardiothoracic and Vascular Anesthesia as well as Xu et al. for reporting interesting outcomes after the use of intravenous iron to treat postoperative functional iron-deficiency anemia in cardiac valvular surgery patients.1 The primary outcome of this randomized, partially blinded clinical trial was a change in hemoglobin on days 7 and 14, and the study was powered accordingly. Patient-centered outcomes were reported only as secondary outcomes, (ie, length of stay, mortality, and adverse postoperative events); although underpowered, none of these were found to be significantly different. Full-Text PDF