Role of intravenous iron therapy for management of perioperative anaemia: A narrative review-ZENTIME PUBLISHING CORPORATION LIMITED

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Role of intravenous iron therapy for management of perioperative anaemia: A narrative review

Mayura Thilanka Iddagoda^1,2, Christopher Etherton-Beer^1,2, Leon Flicker^1,2

¹Perioperative Medical Service, Royal Perth Hospital, Perth, Western Australia 6000, Australia. ²School of Medicine, University of Western Australia, Perth, Western Australia 6000, Australia.

Address correspondence to: Mayura Thilanka Iddagoda, Perioperative Medical Service, Royal Perth Hospital, Wellington Street, Perth, Western Australia 6000, Australia. Phone: +61 8 9224 2244; Email: Mayura.Iddagoda@ health.wa.gov.au.

Acknowledgement: Royal Australasian College of Physicians (Research Entry Scholarship).

DOI: https://doi.org/10.61189/956852bomilz

Received October 23, 2023; Accepted November 21, 2023; Published March 31, 2024

Highlights
● Iron deffciency is the commonest cause for anaemia in patients undergoing surgeries, and this review summarizes its implications.

● Intravenous iron is a better treatment option for iron deffciency than other iron preparations.
● Body iron metabolism is a complex process, and evidence is confficting on iron supplementation in surgical patients.
● Intravenous iron replacement, as a part of patient blood management, has shown benefft in perioperative anaemia.

Abstract

Anaemia is a frequent problem in surgical patients, and the commonest cause is iron deficiency. There is no agreement among perioperative clinicians on the utility of intravenous (IV) iron therapy in surgical patients. In this study, publications in Medline, Web of Science, and Embase databases, along with major perioperative guidelines up until 2022 were searched using speciffc key words, and relevant papers that investigated IV iron therapy in the perioperative settings were screened out. Management of perioperative anaemia is comprehensively discussed in major guidelines. However, the diagnosis and management of iron deffciency is not as straightforward as those for anaemia. Iron metabolism is a complex process. IV iron supplementation remains the treatment choice for perioperative iron deffciency; however, it has limited and confficting evidence of beneffts in surgical patients. IV iron replacement, as a part of patient blood management, has shown benefft in perioperative anaemia.

Keywords: Iron, anaemia, perioperative care, surgery, intravenous

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