Quality -of-life scores ( Piper Fatigue Scale MD 0.73 , 95 % CI 0.29 to 1.18 ; I2 = 0 % ; studies = 3 ) and peak oxygen consumption ( MD 2.77 mL/kg/min , 95 % CI -0.89 to 6.43 ; I2 = 36 % ; 2 studies , 32 participants ) were associated with very low- quality evidence , and we remain uncertain about the role of intravenous iron for these metrics .
Current evidence is insufficient to show benefit of intravenous iron preparations for the treatment of non-anaemic iron deficiency across a variety of patient population s , beyond stating that it may result in a small , clinical ly insignificant increase in haemoglobin concentration .
BACKGROUND Iron deficiency is one of the most common nutritional deficiencies , and has a number of physiological manifestations .
Early , or non-anaemic iron deficiency can result in fatigue and diminished exercise capacity .
Oral iron preparations have a high incidence of intolerable side effects , and are ineffective in certain forms of iron deficiency .
Consequently , intravenous iron preparations are increasingly used in the treatment of non-anaemic iron deficiency .
The newer , more stable iron preparations in particular purport to have a lower incidence of side effects , and are now used across a range of different patient population s. OBJECTIVES To assess the effects of intravenous iron therapy in the treatment of adults with non-anaemic iron deficiency .
Intravenous iron or placebo for anaemia in intensive care: the IRONMAN multicentre randomized blinded trial
Purpose Both anaemia and allogenic red blood cell transfusion are common and potentially harmful in patients admitted to the intensive care unit . Whilst intravenous iron may decrease anaemia and RBC transfusion requirement , the safety and efficacy of administering iron intravenously to critically ill patients is uncertain . Methods The multicentre , r and omized , placebo-controlled , blinded Intravenous Iron or Placebo for Anaemia in Intensive Care ( IRONMAN ) study was design ed to test the hypothesis that , in anaemic critically ill patients admitted to the intensive care unit , early administration of intravenous iron , compared with placebo , reduces allogeneic red blood cell transfusion during hospital stay and increases the haemoglobin level at the time of hospital discharge . Results Of 140 patients enrolled , 70 were assigned to intravenous iron and 70 to placebo . The iron group received 97 red blood cell units versus 136 red blood cell units in the placebo group , yielding an incidence rate ratio of 0.71 [ 95 % confidence interval ( 0.43–1.18 ) , P = 0.19 ] . Overall , median haemoglobin at hospital discharge was significantly higher in the intravenous iron group than in the placebo group [ 107 ( interquartile ratio IQR 97–115 ) vs. 100 g/L ( IQR 89–111 ) , P = 0.02 ] . There was no significant difference between the groups in any safety outcome . Conclusions In patients admitted to the intensive care unit who were anaemic , intravenous iron , compared with placebo , did not result in a significant lowering of red blood cell transfusion requirement during hospital stay . Patients who received intravenous iron had a significantly higher haemoglobin concentration at hospital discharge . The trial was registered at http://www.anzctr.org.au as # ACTRN12612001249842
Quality -of-life scores ( Piper Fatigue Scale MD 0.73 , 95 % CI 0.29 to 1.18 ; I2 = 0 % ; studies = 3 ) and peak oxygen consumption ( MD 2.77 mL/kg/min , 95 % CI -0.89 to 6.43 ; I2 = 36 % ; 2 studies , 32 participants ) were associated with very low- quality evidence , and we remain uncertain about the role of intravenous iron for these metrics .
Current evidence is insufficient to show benefit of intravenous iron preparations for the treatment of non-anaemic iron deficiency across a variety of patient population s , beyond stating that it may result in a small , clinical ly insignificant increase in haemoglobin concentration .
BACKGROUND Iron deficiency is one of the most common nutritional deficiencies , and has a number of physiological manifestations .
Early , or non-anaemic iron deficiency can result in fatigue and diminished exercise capacity .
Oral iron preparations have a high incidence of intolerable side effects , and are ineffective in certain forms of iron deficiency .
Consequently , intravenous iron preparations are increasingly used in the treatment of non-anaemic iron deficiency .
The newer , more stable iron preparations in particular purport to have a lower incidence of side effects , and are now used across a range of different patient population s. OBJECTIVES To assess the effects of intravenous iron therapy in the treatment of adults with non-anaemic iron deficiency .