Cardiothoracic & vascular anesthesia
Perioperative Tracking of Intravenous Iron in Patients Undergoing On-Pump Cardiac Surgery: A Prospective, Single-Center Pilot Trial
Authors' conclusion
The data generate the hypotheses that nearly all FCM is incorporated into iron stores with administration ≥48 hours before surgery. When FCM is given <48 hours of surgery, the majority is incorporated into iron stores by the time of surgery, although a small amount may be lost during surgical bleeding with limited recovery by cell salvage.
Study context
- Population
- Anemic (hemoglobin ≤12/13 g/dL in women and men) and control patients undergoing elective on-pump cardiac surgery13 anemic, 10 control
- Exposure
- Ferric carboxymaltose (FCM) <48 hours vs ≥48 hours before surgery
- Outcome
- FCM tracking before, during and after cardiac surgery with CPB, emphasis on intraoperative iron losses in shed blood and recovery by cell salvage
Methodological detailssingle-centre, FCM measured by liquid chromatography–inductively coupled plasma-mass spectrometry, Blood sampled before surgery and at days 0, 1, 3 and 7; one sample each of CPB, cell salvage RBC concentrate and disposal bag
- Single-centre
- FCM measured by liquid chromatography–inductively coupled plasma-mass spectrometry
- Blood sampled before surgery and at days 0, 1, 3 and 7; one sample each of CPB, cell salvage RBC concentrate and disposal bag
Main finding
As reported in the abstract
FCM serum levels
FCM <48 hours
52.9
median · IQR 13.0–91.6
≥48 hours
2.1
median · IQR 0.7–5.1 · µg/mL
P = 0.008
Observational data: associations, not effects.
Further findings
FCM incorporated (of 500 mg)
| Outcome | FCM <48 hours | ≥48 hours |
|---|---|---|
| Change in plasma FCM concentration after surgery | −27.1 (range −30–-5.9) µg/mL | — not stated in the abstract |
| FCM in cell salvage disposal bag | 4.2 (range 3.0–25.8) µg/mL | |
| Total | 29.0 [19.0-40.7] mg | — not stated in the abstract |
| Share of 500 mg administered | 5.8% or 1/17th | — not stated in the abstract |
| FCM in autologous RBC concentrate | 0.1 (range 0.0–0.43) µg/mL | — not stated in the abstract |
— not stated in the abstract
Original publication
Perioperative Tracking of Intravenous Iron in Patients Undergoing On-Pump Cardiac Surgery: A Prospective, Single-Center Pilot Trial. Anesth Analg. Published 17 February 2023. doi:10.
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