The Effectiveness of Anemia Treatment with Injectable Iron within 48 to 72 Hours before Coronary Artery Bypass Surgery on Cardiac Function and Postoperative Outcome: A Randomized Clinical Trial

Mohammad Jebelli; Mostafa  Sadeghi; Hesam Akbari

doi:10.18502/jimc.v7i4.16639

Mohammad Jebelli Department of Cardiovascular Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Mostafa Sadeghi Department of Anesthesiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Hesam Akbari Department of Cardiovascular Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jimc.v7i4.16639

Keywords: Anemia, Iron-Deficiency, Ferric oxide, Saccharated, Humans, Iron, Iron deficiencies, Left ventricular function, Saline solution, Single-blind method, Stroke volume, Sucrose

Abstract

Background: Anemia is considered as one of the risk factors affecting the outcomes after cardiac surgery. Accordingly, the improvement of iron deficiency anemia through injection or oral may be associated with the improvement of post-procedure results, especially the improvement of cardiovascular function. This study was aimed at investigating the effectiveness of iron treatment shortly before surgery in reducing the need for blood transfusion and improving myocardial performance parameters (left ventricular ejection fraction) in coronary bypass surgery patients.

Methods: This study was a single-blind randomized clinical trial. In total, 60 candidates for coronary bypass surgery having iron deficiency anemia before the operation were randomly divided into two groups treated with injectable iron supplement (iron sucrose at a dose of 200 mg/200 ml of normal saline injected in 30 minutes) 48 to 72 hours before surgery or without therapeutic intervention. The patients were examined during and after the operation in terms of surgical outcomes.

Results: Treatment with injectable iron before surgery was associated with improvement in serum hemoglobin level after surgery and a significant reduction in the need for intraoperative and postoperative transfusions. Preoperative treatment of iron deficiency was associated with a reduction in the length of hospitalization of the patients after surgery.

Conclusion: Treatment of iron deficiency anemia within 48 to 72 hours before surgery will improve the condition of patients’ anemia and compensate serum hemoglobin, reduce the need for blood transfusion during surgery and the length of hospitalization of the patients after surgery.