ANEMIA IN CRITICALLY ILL AND SURGICAL PATIENT; TREATMENT WITH INTRAVENOUS IRON

Background: Anemia is a common condition among surgical and critically ill patients and it is usually treated with allogenic blood transfusion (ABT). As ABT is associated with increased morbidity and mortality, alternative therapies for anemia in these patients are actively investigated. Objectives: To asses the potential usefulness of intravenous iron therapy in critically-ill or surgical patients with anemia. Methods: Review of published papers with intravenous iron in these patients. Bibliographical search on database Medline (www.ncvi.nlm.nih.gov). Results and discussion: Treatment with intravenous iron is not sufficient to treat the anemia of critically ill patients. Its association with erythropoietin (EPO) may have an effect on the rate of ABT, but it has not been shown to improve morbidity, mortality or length of hospital stay. In gastrointestinal or trauma surgery there is no evidence to support the routine preoperative treatment with intravenous iron, although it may be beneficial when it is used with erythropoietin. Intravenous iron alone or in combination with EPO in the postoperative period has not been proved useful for rapid correction of anemia, reduction of hospital stay or mortality.