Hemodynamics, fluids & transfusion
Efficacy and safety of intravenous iron supplementation for perioperative iron deficiency anemia: a systematic review and network meta-analysis of randomized controlled trials
Authors' conclusion
FCM improves perioperative Hb concentrations and reduces transfusion requirements. All intravenous iron preparations demonstrated acceptable safety profiles.
Study context
- Population
- Perioperative patients with iron deficiency anemia receiving intravenous iron
- Participants
- 4,688 patients · 34 randomized controlled trials (RCTs)
- Comparison
- Intravenous iron preparations vs placebo
- Outcome
- Hemoglobin (Hb) concentrations
Methodological detailsBayesian network meta-analysis (NMA)
- Bayesian NMA
Pooled result
As reported in the abstract
Each group vs placeboMD, g/dL (95 % CrI)
FCM
0.76(0.56–0.96)
IIM
0.65(0.33–0.97)
Further pooled results
| Outcome | OR (95 % CrI) | |
|---|---|---|
| Transfusion requirementsFCM vs Placebo · CrI | 0.72 (0.55–0.91) | |
| 0.512Odds ratio (log scale) |
Transfusion requirements
- Only ferric carboxymaltose (FCM) reduced transfusion requirements
Quality of life (QoL) (descriptive analysis)
- Improved QoL with FCM vs placebo for fatigue and dyspnea (QLQ-C30) and physical functioning (SF-36)
NMA consistency
- No significant inconsistencies between direct and indirect evidence
Safety
- No significant differences in adverse events between the groups
Original publication
Efficacy and safety of intravenous iron supplementation for perioperative iron deficiency anemia: a systematic review and network meta-analysis of randomized controlled trials. J Clin Anesth. Published 3 November 2025. doi:10.
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