Torres Susan, Kuo Yen-Hong, Morris Kimo, Neibart Richard, Holtz Jane Bliss, Davis John Mihran
Ann May Center for Nursing, Jersey Shore University Medical Center, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey 07753, USA.
Surg Infect (Larchmt). 2006 Aug;7(4):361-6. doi: 10.1089/sur.2006.7.361.
Intravenous iron (FeIV) has been used increasingly, alone or in combination with recombinant erythropoietin, to promote red cell production as part of a blood conservation program. Given the important role that iron plays in the growth of bacteria, it has been hypothesized that this use of FeIV may promote surgical site infection. However, this hypothesis has not yet been tested appropriately. To assess this hypothesis, postoperative infection rates in patients undergoing cardiothoracic surgery were analyzed.
Data were collected on 863 patients undergoing cardiopulmonary bypass surgery in 2001. Patients were either enrolled voluntarily in a blood conservation program in which they received either postoperative FeIV and erythropoietin (n=302), as indicated, or blood transfusions and no FeIV (n=561), as indicated, to correct postoperative anemia. Infections were defined according to the U.S. Centers for Disease Control and Prevention guidelines.
Thirty-nine infections developed. The overall infection rate was 4.52%, with an infection rate of 3.97% in the iron-treated group (n=12) and a rate of 4.81% in the untreated group (n=27). When the impact of gender, age, diabetes mellitus, operating time, type of surgery, and blood transfusions were controlled for, FeIV did not increase the risk of infection (odds ratio of 1.031 for each increment of 125 mg of FeIV; 95% confidence interval 0.908, 1.170; p=0.64).
There was no impact of FeIV on the subsequent infection rate in a cardiac surgery patient cohort, indicating its safety for use in the postoperative setting.
静脉铁剂（FeIV）越来越多地单独或与重组促红细胞生成素联合使用，以促进红细胞生成，作为血液保护计划的一部分。鉴于铁在细菌生长中所起的重要作用，有人推测这种FeIV的使用可能会促进手术部位感染。然而，这一假设尚未得到充分验证。为了评估这一假设，分析了接受心胸外科手术患者的术后感染率。
收集了2001年接受体外循环手术的863例患者的数据。患者自愿参加血液保护计划，根据情况，他们接受术后FeIV和促红细胞生成素（n = 302），或输血且不接受FeIV（n = 561），以纠正术后贫血。感染根据美国疾病控制与预防中心的指南进行定义。
发生了39例感染。总体感染率为4.52%，铁剂治疗组的感染率为3.97%（n = 12），未治疗组的感染率为4.81%（n = 27）。在控制了性别、年龄、糖尿病、手术时间、手术类型和输血的影响后，FeIV并未增加感染风险（每增加125 mg FeIV的比值比为1.031；95%置信区间0.908, 1.170；p = 0.64）。
FeIV对心脏手术患者队列的后续感染率没有影响，表明其在术后使用是安全的。
