Supplement intravenous iron therapy in cardiac surgery

Abstract

 Introduction. Preoperative anemia which is present in 25–40 % of cardiac surgery patients increases the risk of adverse postoperative outcomes leading to higher medical expenses. The tendency to restrict allogenic transfusion rate has led to the search for new pharmacological solutions to correct anemia in the perioperative period, nevertheless the usage of intravenous iron preparations in cardiac surgery is still not a generally accepted standard of treatment.Aim — review of the literature about the effects of perioperative intravenous iron therapy on the clinical outcomes in cardiac surgery.Main findings. The use of intravenous iron preparations during the perioperative period in cardiac surgery results in better hemoglobin dynamics, iron repletion and less demand for allogenic transfusions. Anemia correction and lower transfusion rate might improve surgery outcomes such as mortality, intensive care unit length of stay and hospital length of stay. Iron repletion, regardless of presence of anemia, might improve the results of 6-minute walk test and patients’ quality of life after surgery. The optimal time for intravenous iron therapy in cardiac surgery is 10–14 days before surgery or immediately after the intervention. Ferric carboxymaltose can be administered in a single injection/infusion shortly before or after surgery.