scholarly journals The Effect of Intraoperative Ferric Carboxymaltose in Joint Arthroplasty Patients: A Randomized Trial

2019 ◽  
Vol 8 (10) ◽  
pp. 1674 ◽  
Author(s):  
Hee-Sun Park ◽  
Tae-Yop Kim ◽  
Ha-Jung Kim ◽  
Young-Jin Ro ◽  
Hwa-Young Jang ◽  
...  
Keyword(s):  
Intravenous Iron ◽  
Controlled Study ◽  
Ferric Carboxymaltose ◽  
High Dose ◽  
Transfusion Rate ◽  
Functional Iron Deficiency ◽  
Post Surgery ◽  
Total Arthroplasty ◽  
Total Knee ◽  
Intravenous Iron Therapy

This study assessed the efficacy of intraoperative high-dose intravenous iron therapy in facilitating recovery from postoperative anemia and reducing the transfusion rate in patients with total knee and total hip arthroplasty. This prospective randomized controlled study involved 58 subjects. Group F received 1000 mg intravenous ferric carboxymaltose and Group C received normal saline. The changes in hemoglobin (Hb), hematocrit, iron metabolism variables, transfusion rates, and the arterial partial pressure of oxygen and the fraction of oxygen (PaO2/FiO2) ratio were recorded. There were 29 patients of each group. The change in Hb levels from baseline to 1 month post-surgery was higher in Group F than in Group C (0.3 ± 1.0 g/dl vs. −0.8 ± 0.8 g/dl, p < 0.001). Functional iron deficiency occurred more frequently in Group C (0% vs. 48.3%, p < 0.001) after the operation. The incidence of postoperative anemia, transfusion rate and P/F ratio did not significantly differ between the two groups. This study suggests that intraoperative high-dose ferric carboxymaltose during lower limb total arthroplasty can facilitate the recovery from postoperative anemia. Although it could not prevent the occurrence of postoperative anemia or the administration of transfusion, this treatment seemed to overcome surgery-related decrease of iron availability.

scholarly journals Oral and Intravenous Iron Therapy Differentially Alter the On- and Off-Tumor Microbiota in Anemic Colorectal Cancer Patients

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1341
Author(s):  
Oliver Phipps ◽  
Hafid O. Al-Hassi ◽  
Mohammed N. Quraishi ◽  
Edward A. Dickson ◽  
Jonathan Segal ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Ferrous Sulphate ◽  
Intravenous Iron ◽  
Oral Iron ◽  
Iron Therapy ◽  
Deficiency Anemia ◽  
Ferric Carboxymaltose ◽  
Β Diversity ◽  
Post Surgery ◽  
Intravenous Iron Therapy

Iron deficiency anemia is a common complication of colorectal cancer and may require iron therapy. Oral iron can increase the iron available to gut bacteria and may alter the colonic microbiota. We performed an intervention study to compare oral and intravenous iron therapy on the colonic tumor-associated (on-tumor) and paired non-tumor-associated adjacent (off-tumor) microbiota. Anemic patients with colorectal adenocarcinoma received either oral ferrous sulphate (n = 16) or intravenous ferric carboxymaltose (n = 24). On- and off-tumor biopsies were obtained post-surgery and microbial profiling was performed using 16S ribosomal RNA analysis. Off-tumor α- and β-diversity were significantly different between iron treatment groups. No differences in on-tumor diversity were observed. Off-tumor microbiota of oral iron-treated patients showed higher abundances of the orders Clostridiales, Cytophagales, and Anaeroplasmatales compared to intravenous iron-treated patients. The on-tumor microbiota was enriched with the orders Lactobacillales and Alteromonadales in the oral and intravenous iron groups, respectively. The on- and off-tumor microbiota associated with intravenous iron-treated patients infers increased abundances of enzymes involved in iron sequestration and anti-inflammatory/oncogenic metabolite production, compared to oral iron-treated patients. Collectively, this suggests that intravenous iron may be a more appropriate therapy to limit adverse microbial outcomes compared to oral iron.

scholarly journals Oral and Intravenous Iron Therapy Differentially Alter The on- and Off-Tumour Microbiota in Anaemic Colorectal Cancer Patients.

2021 ◽  
Author(s):  
Oliver Phipps ◽  
Hafid Omar Al-Hassi ◽  
Mohammed Nabil Quraishi ◽  
Edward A Dickson ◽  
Jonathan Segal ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Ferrous Sulphate ◽  
Intravenous Iron ◽  
Oral Iron ◽  
Iron Therapy ◽  
Ferric Carboxymaltose ◽  
Large Shift ◽  
Post Surgery ◽  
Anti Inflammatory ◽  
Intravenous Iron Therapy

Abstract Background Iron deficiency anaemia is a common complication of colorectal cancer and may require iron therapy. Oral iron can increase iron available to gut bacteria and may alter the colonic microbiota. We performed an intervention study to compare oral and intravenous iron therapy on the colonic tumour-associated (on-tumour) and paired non-tumour-associated adjacent (off-tumour) microbiota. Anaemic patients with colorectal adenocarcinoma received either oral ferrous sulphate (n=16) or intravenous ferric carboxymaltose (n=24). On- and off-tumour biopsies were obtained post-surgery and microbial profiling was performed using 16S ribosomal RNA analysis.Results Off-tumour α- and β-diversity were significantly different between iron treatment groups. No differences in on-tumour diversity were observed. Off-tumour microbiota of oral iron-treated patients shows higher abundances of the orders Clostridiales, Cytophagales and Anaeroplasmatales compared to intravenous iron-treated patients. The on-tumour microbiota was enriched with the orders Lactobacillales and Alteromonadales in the oral and intravenous iron groups, respectively. The on- and off-tumour microbiota associated with intravenous iron-treated patients infers increased abundances of enzymes involved in iron sequestration and anti-inflammatory/oncogenic metabolite production, compared to oral iron-treated patients. Paired on- and off-tumour microbiota show large taxonomic differences in intravenous iron-treated patients and limited differences in oral iron-treated patients.Conclusion Oral iron shows a large shift in the off-tumour microbiota, but a more limited change in on-tumour microbiota. The on- and off-tumour microbiota in intravenous iron-treated patients infers a microbiota associated with anti-inflammatory and tumour protective pathways. Suggesting intravenous iron may be a more appropriate therapy to limit adverse microbial outcomes, compared to oral iron.Trial registration: NCT01701310. Registered 21 March 2012, https://clinicaltrials.gov/ct2/show/NCT01701310

scholarly journals Hypophosphataemia after intravenous iron therapy with ferric carboxymaltose—Real world experience from a tertiary centre in the UK

GastroHep ◽  
2020 ◽  
Vol 2 (5) ◽  
pp. 205-214 ◽  
Author(s):  
Konstantinos C. Fragkos ◽  
Vinay Sehgal ◽  
Jennifer Rogers ◽  
Sithhipratha Arulrajan ◽  
Pranavan Pavanerathan ◽  
...  
Keyword(s):  
Real World ◽  
Intravenous Iron ◽  
Iron Therapy ◽  
Ferric Carboxymaltose ◽  
Tertiary Centre ◽  
Intravenous Iron Therapy ◽  
The Uk

scholarly journals The effects of intra-articular tranexamic acid given intraoperatively and intravenous tranexamic acid given preoperatively on post surgical bleeding and transfusion rate post total knee arthroplasty

2017 ◽  
Vol 25 (4) ◽  
pp. 234-9 ◽  
Author(s):  
Aryo N. Triyudanto ◽  
Andri M.T. Lubis
Keyword(s):  
Blood Transfusion ◽  
Tranexamic Acid ◽  
Postoperative Bleeding ◽  
Control Group ◽  
Transfusion Rate ◽  
Intraoperative Bleeding ◽  
Post Surgery ◽  
Drain Removal ◽  
Significant Difference ◽  
Total Knee

Background: Despite the advances in the design and fixation of implants in total knee replacement (TKR). the amount of postoperative bleeding is still an important issue that has not been resolved. This study aimed to measure the effectiveness of various tranexamic acid administration. Methods: This was a randomized controlled trial study, held from August 2014 to February 2016 at Cipto Mangunkusumo Hospital, Jakarta. Twenty two patients having TKR were divided into three groups: the control group, the tranexamic acid intra-articular-intraoperative group, and the intravenous preoperative group. Intraoperative bleeding, haemoglobin (Hb) level on preoperative to five-day-post-surgery, total drain production, total blood tranfusion needed and the drain removal timing were recorded and compared. Numerical data were analyzed by using parametric and non-parametric test, depended on the normality of the data. Results: The amount of blood transfusion needed in both the intra-articular group (200±SD 100 mL) and the intravenous group (238±SD 53 mL) were significantly different compared to those in the control group (1,016±SD 308.2 mL) (p=0.001). Meanwhile, there was no significant difference between the amount of blood transfusion needed in the intra-articular group and the intravenous group. Total drain production in the intra-articular group (328±SD 193 mL) and intravenous group (391±SD 185 mL) was significantly different compared to the control group (652±SD 150 mL) (p=0.003). No significant difference between the levels of both preoperative and postoperative haemoglobin, the amount of intraoperative bleeding, and the duration of drain usage. Conclusion: Intravenous and intra-articular tranexamic acid effectively decreased transfusion volume and drain production in patients undergoing TKR.

scholarly journals Life Threatening Rapid Onset of Hypophosphatemia Induced by Intravenous Iron Treatment Following Pulmonary Resection

2020 ◽  
Author(s):  
Eren Erdoğdu ◽  
Fahmin Amirov ◽  
Özlem Turhan ◽  
Berker Özkan ◽  
Zerrin Sungur ◽  
...  
Keyword(s):  
Wedge Resection ◽  
Clinical Status ◽  
Intravenous Iron ◽  
Perioperative Period ◽  
Rapid Onset ◽  
Microcytic Anemia ◽  
Parenteral Administration ◽  
Ferric Carboxymaltose ◽  
High Dose ◽  
Iron Replacement

Severe hypophosphatemia is a rare electrolyte disturbance among surgical patients associated with severe fatigue, impaired cardiac and respiratory functions. Although mild hypophosphatemia is common after parenteral administration of intravenous iron replacement, severe hypophosphatemia is not usual in perioperative period. We present a case of 76-year-old female who underwent surgery for a left paramediastinal mass. Laboratory examination showed hypochromic microcytic anemia. A total dose of parenteral 1000 mg ferric carboxymaltose was administered two days prior to the operation with the aim of achieving a rapid increase in hemoglobin. We performed a wedge resection for the mass originating from the left upper lobe. The patient developed dyspnea and fatigue with severe hypophosphatemia on postoperative third day. The clinical status of the patient could be only improved with parenteral administration of high dose of sodium phosphate. We tried to emphasize this unexpected complication of intravenous iron replacement and the features of its management.

Sign in / Sign up

Export Citation Format

Share Document