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DGI-064 Study of the Use of Ferric Carboxymaltose (FC) Within the System For Preoperative Optimization of Haemoglobin (Hb) in Scheduled Surgery
  1. M Gómez Pérez,
  2. MA Arias Moya,
  3. M Hernández Segurado,
  4. FJ Bécares Martínez,
  5. M Bonilla Porras,
  6. E Castillo Bazán,
  7. MI Panadero Esteban,
  8. G Toledano Mayoral,
  9. B Rodríguez Vargas,
  10. EM Martín Gozalo
  1. Hospital Universitario Fundación Jimenez Diaz, Pharmacy, Madrid, Spain

Abstract

Background In our hospital there is a protocol for preoperative Hb optimization with the aim of reducing blood transfusions in patients with anaemia and upcoming surgery.

Purpose To evaluate the use of FC in terms of adherence to protocol and effectiveness.

Materials and Methods Descriptive observational study. The study included patients who had received at least one dose of FC in 2011. We collected from the electronic medical record: age, sex, cause of anaemia, iron administered, Hb level, iron saturation, transferrin and ferritin before administration of IV iron and surgery. We evaluated adherence to the protocol and analytical results.

Results We studied 47 patients with an age range between 23 and 87 years (median = 62). 78.7% of the patients met the optimization of Hb protocol (inclusion criteria: anaemia and upcoming surgery).

The average increases in Hb after a single administration of 500 mg and 1000 mg of FC were 0.6 g/dl and 1 g/dl respectively. In the case of patients who had also been given other forms of IV iron before surgery (total average dose of iron administered: 1150 mg) levels increased by a median of 2.05 g/dl. Erythropoietin was also administered to 32.43% of the patients. The mean differences in the rest of the analytical parameters studied before and after administration of iron IV were: serum iron: 40.7 µg/dl, %, iron saturation: 15.8%, transferrin: −41.8 mg/dl ferritin: 378.1 ng/ml. The median time between administration and surgery was 6 days.

Conclusions Our results show a fast increase in Hb in a short time. Restriction of the FC implied making a good selection of patients who may benefit from the higher dose (average increase of 2.05 g/dl needs an average dose of 1150 mg iron to be administered) and higher speed of action (median time between administration and surgery: 6 days). Its use would be justified for fast increases in Hb when, due to the impending surgery, with they would not be obtained in time with other presentations of iron.

Mean differences (for average dose of iron administered: 891.89 mg) in patients who met the Hb optimization protocol

Abstract DGI-064 Table 1

No conflict of interest.

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