Division of Hematology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Division of Pharmacy, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Pediatr Blood Cancer. 2018 Jun;65(6):e26995. doi: 10.1002/pbc.26995. Epub 2018 Jan 25.
Iron deficiency is a common and clinically diverse hematologic disorder in childhood for which oral iron is often an infeasible or ineffective treatment option. Intravenous (IV) iron can be an efficient and highly successful means of iron replacement but its use has not been well-characterized on a large scale in pediatrics.
All IV iron doses administered to patients for iron replacement therapy at a tertiary pediatric hospital from January 2010 through October 2016 were evaluated. Analyses included patient demographics, underlying medical conditions, and detailed information for each dose. Individual chart review was performed to identify infusion-related reactions. Nephrology patients as well as those patients 21 years or older at the time of the first infusion were excluded.
A total of 1,088 doses of IV iron administered to 194 patients met inclusion criteria. A wide variety of specialties prescribed IV iron, with gastroenterology, hematology, and hospital medicine being the highest users in this cohort. A majority of patients (68%) required multiple infusions and dosing was highly variable, ranging from 1.3-1,030 mg per infusion. Premedication use was infrequent (10.3% of doses) and no severe infusion-associated reactions occurred.
IV iron is commonly prescribed by certain pediatric specialties but there is little standardization in the indications, formulations, or dosing. These data suggest that IV iron should be considered a safe alternative for iron deficiency treatment in pediatrics when oral iron is either unsuccessful or contraindicated.
缺铁是儿童期常见且临床表现多样的血液系统疾病，口服铁剂通常是一种不可行或无效的治疗选择。静脉（IV）铁可以作为一种高效且非常成功的铁替代方法，但在儿科领域，其大规模应用尚未得到很好的描述。
评估了 2010 年 1 月至 2016 年 10 月期间，一家三级儿科医院为铁替代治疗而向患者输注的所有 IV 铁剂量。分析包括患者的人口统计学特征、基础疾病以及每剂药物的详细信息。通过单独的图表审查来确定与输注相关的不良反应。排除肾病患者以及首次输注时年龄在 21 岁或以上的患者。
共有 194 名患者的 1088 剂 IV 铁符合纳入标准。许多科室都开具了 IV 铁，其中以胃肠病学、血液学和医院医学为最高用量科室。大多数患者（68%）需要多次输注，且剂量差异很大，每剂 1.3-1030mg 不等。预处理药物的使用频率较低（10.3%的剂量），且未发生严重的输注相关不良反应。
某些儿科专科常开具 IV 铁，但在适应证、制剂或剂量方面几乎没有标准化。这些数据表明，当口服铁剂无效或禁忌时，IV 铁应被视为儿科缺铁治疗的一种安全替代方法。
