Stephen Su Yang1,2, Latifa Al Kharusi3, Adam Gosselin3, Anissa Chirico3, Pouya Gholipour Baradari3, Matthew J Cameron3,4. 1. Faculty of Medicine, McGill University, Montreal, QC, Canada. stephen.yang@mail.mcgill.ca. 2. Division of Critical Care, Department of Anesthesia, Jewish General Hospital, K1400-3755, Cote Sainte Catherine, Montreal, QC, H3T 1E2, Canada. stephen.yang@mail.mcgill.ca. 3. Faculty of Medicine, McGill University, Montreal, QC, Canada. 4. Division of Critical Care, Department of Anesthesia, Jewish General Hospital, K1400-3755, Cote Sainte Catherine, Montreal, QC, H3T 1E2, Canada.
Abstract
PURPOSE: Iron supplementation has been evaluated in several randomized controlled trials (RCTs) for its potential to increase baseline hemoglobin and decrease red blood cell transfusion during cardiac surgery. This study's main objective was to evaluate the current evidence for iron administration in cardiac surgery patients. METHODS: We searched MEDLINE, EMBASE, CENTRAL, Web of Science databases, and Google Scholar from inception to 19 November 2020 for RCTs evaluating perioperative iron administration in adult patients undergoing cardiac surgery. The RCTs were assessed using a risk of bias assessment and the quality of evidence was assessed using the grading of recommendations, assessments, development, and evaluations. RESULTS: We reviewed 1,767 citations, and five studies (n = 554) met the inclusion criteria. The use of iron showed no statistical difference in incidence of transfusion (risk ratio, 0.86; 95% confidence interval, 0.65 to 1.13). Trial sequential analysis suggested an optimal information size of 1,132 participants, which the accrued information size did not reach. CONCLUSION: The current literature does not support or refute the routine use of iron therapy in cardiac surgery patients. TRIAL REGISTRATION: PROSPERO (CRD42020161927); registered 19 December 2019.
PURPOSE: Iron supplementation has been evaluated in several randomized controlled trials (RCTs) for its potential to increase baseline hemoglobin and decrease red blood cell transfusion during cardiac surgery. This study's main objective was to evaluate the current evidence for iron administration in cardiac surgery patients. METHODS: We searched MEDLINE, EMBASE, CENTRAL, Web of Science databases, and Google Scholar from inception to 19 November 2020 for RCTs evaluating perioperative iron administration in adult patients undergoing cardiac surgery. The RCTs were assessed using a risk of bias assessment and the quality of evidence was assessed using the grading of recommendations, assessments, development, and evaluations. RESULTS: We reviewed 1,767 citations, and five studies (n = 554) met the inclusion criteria. The use of iron showed no statistical difference in incidence of transfusion (risk ratio, 0.86; 95% confidence interval, 0.65 to 1.13). Trial sequential analysis suggested an optimal information size of 1,132 participants, which the accrued information size did not reach. CONCLUSION: The current literature does not support or refute the routine use of iron therapy in cardiac surgery patients. TRIAL REGISTRATION: PROSPERO (CRD42020161927); registered 19 December 2019.
Authors: Huseyin Naci; Courtney Davis; Jelena Savović; Julian P T Higgins; Jonathan A C Sterne; Bishal Gyawali; Xochitl Romo-Sandoval; Nicola Handley; Christopher M Booth Journal: BMJ Date: 2019-09-18
Authors: Matthew C Frise; David A Holdsworth; Manraj S Sandhu; Adrian J Mellor; Adetayo S Kasim; Helen C Hancock; Rebecca H Maier; Keith L Dorrington; Peter A Robbins; Enoch F Akowuah Journal: J Cardiothorac Surg Date: 2022-06-16 Impact factor: 1.522