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Effects of intravenous iron combined with low-dose recombinant human erythropoietin on transfusion requirements in iron-deficient patients undergoing bilateral total knee replacement arthroplasty . BACKGROUND The authors examined the impact of parenteral iron and recombinant human erythropoietin-β ( rHuEPO-β ) administered in the bilateral total knee replacement arthroplasty ( TKRA ) , on postoperative anemia and transfusion requirements in iron-deficient patients . STUDY DESIGN AND METHODS A total of 108 iron-deficient patients were randomly assigned to two groups : Group C ( control ) or Group IE ( 200 mg of iron sucrose intravenously over 1 hr and 3000 IU of rHuEPO-β subcutaneously during the operation and during the postoperative period if the hemoglobin [ Hb ] level was 70-80 g/L ) . One or 2 units of blood were transfused to patients in both groups according to postoperative Hb level ( between 60 and 70 g/L or betweeen 50 and 60 g/L , respectively ) . Perioperative laboratory and clinical outcomes ( Hb , iron variables , postoperative bleeding amount , and number of units of RBCs transfused and incidences ) were documented . RESULTS Although preoperative Hb and the amount of postoperative bleeding were comparable in the two groups , Hb levels at 1 , 2 , and 3 days and at 2 and 6 weeks postoperation were significantly higher in Group IE . Furthermore , the transfusion rate was significantly lower in Group IE ( 20.4 % vs. 53.7 % , p=0.011 ) and the mean number of red blood cell units transfused was markedly lower in Group IE ( 0.2±0.5 vs. 0.8±0.8 , p=0.005 ) . Postoperative iron , ferritin , and transferrin saturation levels were significantly higher in Group IE . CONCLUSIONS Treatment with parenteral iron and low-dose rHuEPO-β in bilateral TKRA effectively attenuated anemia and decreased transfusion requirements in iron-deficient patients .
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Intervention_Pharmacological
intravenous iron combined with low-dose recombinant human erythropoietin
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Outcome_Other
Effects
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Outcome_Other
transfusion requirements
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Participant_Condition
iron-deficient patients undergoing bilateral total knee replacement arthroplasty .