Department of Cardiac Surgery, Rambam Health Care Campus, Haifa, Israel; Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.
Blood Bank and Apheresis Unit, Rambam Health Care Campus, Haifa, Israel; Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel; Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.
Br J Anaesth. 2023 Dec;131(6):981-988. doi: 10.1016/j.bja.2023.09.007. Epub 2023 Oct 12.
Reducing the need for blood transfusion among patients undergoing cardiac surgery FLA reduce postoperative complications and mortality. Our study aimed to assess the effects of administering preoperative i.v. ferric carboxymaltose on postoperative red cell transfusion requirements in patients without anaemia undergoing on-pump cardiac surgery.
This double-blind, randomised, placebo-controlled trial was conducted between October 2016 and November 2019, with a follow-up period of up to 6 weeks after surgery. Patients without anaemia who underwent on-pump cardiac surgery were included as participants and administered i.v. iron in the form of ferric carboxymaltose or placebo once, 24-72 h before surgery. The primary outcome was the number of red cell units transfused during the first four postoperative days, and the secondary outcome measures were blood haemoglobin concentrations at 4 days and 6 weeks after surgery.
The 200 patients included were randomly assigned to the ferric carboxymaltose (n=102) and placebo (n=98) groups. By postoperative Day 4, a significantly lower mean number of red cell units were transfused in the ferric carboxymaltose than in the placebo group, 0.3 (0.8) vs 1.6 (4.4), respectively; P=0.007. The mean haemoglobin concentrations on postoperative Day 4 were 9.7 (1) g dl and 9.3 (1) g dl, respectively (P=0.03). Corresponding values at 6 weeks after surgery were 12.6 (1.4) g dl and 11.8 (1.5) g dl, respectively (P=0.012).
In patients without anaemia undergoing on-pump cardiac surgery, treatment with a single dose of 1000 mg ferric carboxymaltose i.v. 1-3 days before surgery significantly reduced the need for red cell transfusions and increased the postoperative haemoglobin concentration.
NCT02939794.
减少心脏手术患者对输血的需求可以降低术后并发症和死亡率。我们的研究旨在评估术前静脉注射羧基麦芽糖铁对非贫血行体外循环心脏手术患者术后红细胞输注需求的影响。
这是一项双盲、随机、安慰剂对照试验，于 2016 年 10 月至 2019 年 11 月进行，术后随访期最长为 6 周。纳入非贫血且行体外循环心脏手术的患者，在术前 24-72 小时内接受羧基麦芽糖铁或安慰剂静脉注射一次。主要结局为术后前 4 天内输注的红细胞单位数，次要结局指标为术后第 4 天和第 6 周的血红蛋白浓度。
共纳入 200 例患者，随机分为羧基麦芽糖铁组（n=102）和安慰剂组（n=98）。术后第 4 天，羧基麦芽糖铁组输注的平均红细胞单位数明显少于安慰剂组，分别为 0.3（0.8）与 1.6（4.4）；P=0.007。术后第 4 天的平均血红蛋白浓度分别为 9.7（1）g/dl 和 9.3（1）g/dl；P=0.03。术后 6 周的相应值分别为 12.6（1.4）g/dl 和 11.8（1.5）g/dl；P=0.012。
在非贫血行体外循环心脏手术的患者中，术前 1-3 天给予 1000mg 羧基麦芽糖铁静脉注射 1 次可显著减少红细胞输注需求，并增加术后血红蛋白浓度。
NCT02939794。
