Abstract
IntroductionPostoperative anaemia can affect more than 90% of patients undergoing major surgeries. Patients develop an absolute iron deficiency in the face of significant blood loss or preoperative anaemia and major surgery. Studies have shown the negative impact of these factors on transfusion requirements, infections, increased hospitalisation and long-term morbidities.Aim of the studyThe research was performed to determine the correlation between intravenous iron administration in the postoperative period and improved haemoglobin correction trend.Material and methodsA prospective study was conducted to screen and treat iron deficiency in patients undergoing major surgery associated with significant bleeding. For iron deficiency anaemia screening, in the postoperative period, the following bioumoral parameters were assessed: haemoglobin, serum iron, transferrin saturation (TSAT), and ferritin, direct serum total iron-binding capacity (dTIBC), mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH). In addition, serum glucose, fibrinogen, urea, creatinine and lactate values were also collected.ResultsTwenty-one patients undergoing major surgeries (52,38% were emergency and 47,61% elective interventions) were included in the study. Iron deficiency, as defined by ferritin 100-300 μg/L along with transferrin saturation (TSAT) < 20 %, mean corpuscular volume (MVC) < 92 fL, mean corpuscular haemoglobin (MCH) < 33 g/dL, serum iron < 10 μmol/L and direct serum total iron-binding capacity (dTIBC) > 36 μmol/L, was identified in all cases. To correct the deficit and optimise the haematological status, all patients received intravenous ferric carboxymaltose (500-1000 mg, single dose). Using Quadratic statistical analysis, the trend of haemoglobin correction was found to be a favourable one.ConclusionThe administration of intravenous ferric carboxymaltose in the postoperative period showed the beneficial effect of this type of intervention on the haemoglobin correction trend in these groups of patients.
Highlights
Postoperative anaemia can affect more than 90% of patients undergoing major surgeries
Preoperative anaemia has a prevalence of approximately 40% of patients, reaching 90% after major surgeries [2,3,4]
Various studies have shown the negative impact of anaemia and iron deficiency in surgical patients, leading to increased red blood cells transfusion requirements, infections, slower recovery, ischemic complications, acute kidney injury [12], prolonged length of hospital stay, increased readmission, a more unsatisfac
Summary
Postoperative anaemia can affect more than 90% of patients undergoing major surgeries. Patients develop an absolute iron deficiency in the face of significant blood loss or preoperative anaemia and major surgery. In case of significant blood volume loss, due to major surgery or prolonged hospitalisation [7], anaemia can develop or worsen, and it is usually associated with absolute or functional iron deficiency (the erythropoietic response is increased and outstrips the actual iron supply) [8, 9]. Various studies have shown the negative impact of anaemia and iron deficiency in surgical patients, leading to increased red blood cells transfusion requirements, infections, slower recovery, ischemic complications (especially myocardial infarction), acute kidney injury [12], prolonged length of hospital stay, increased readmission, a more unsatisfac-
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