Pre-Operative IV Iron Infusion for Vascular Patients: Need for More Evidence (Case Series)

Abstract

Pre-operative anaemia is present in approximately 30% of patients undergoing noncardiac surgery [1]. The presence of pre-operative anaemia is the strongest predictor of perioperative blood transfusion and is an independent risk factor for post-operative morbidity and mortality [2]. It is well known that Red Blood Cells (RBC) transfusion can increase the surgical length of stay, increase mortality in surgical patients, and expose patients to the risk of circulatory overload, acute lung injury, and immunosuppression [3-5]. Sufficient data exist to support intravenous iron as efficacious and safe. Intravenous iron should be used as front-line therapy in patients who do not respond to oral iron or are not able to tolerate it, or if surgery is planned for <6 weeks after the diagnosis of iron deficiency [6]. The European Medicines Agency concluded that the benefits of i.v. iron exceed the risks when used appropriately (correct indication and dose), without any difference in safety profile among available formulations [7]. We report two vascular cases had peri-operative i.v iron treatment for anaemia.