Safety and efficacy of iron therapy on reducing red blood cell transfusion requirements and treating anaemia in critically ill adults: A systematic review with meta-analysis and trial sequential analysis.
J Crit Care
; 49: 162-171, 2019 02.
Article
en En
| MEDLINE
| ID: mdl-30448516
ABSTRACT
PURPOSE:
To evaluate the safety (risk of infection) and efficacy (transfusion requirements, changes in haemoglobin (Hb)) of iron therapy in adult intensive care unit (ICU) patients. MATERIALS ANDMETHODS:
We systematically searched seven databases for all relevant studies until January 2018 and included randomized (RCT) studies comparing iron, by any route, with placebo/no iron.RESULTS:
805 participants from 6 RCTs were included. Iron therapy, by any route, did not decrease the risk of requirement for a red blood cell (RBC) transfusion (Risk ratio (RR) 0.91, 95% CI 0.80 to 1.04, pâ¯=â¯0.15) or mean number of RBCs transfused per participant (mean difference (MD) -0.30, 95% CI -0.68 to 0.07, pâ¯=â¯0.15). Iron therapy did increase mean Hb concentration (MD 0.31â¯g/dL, 95% CI 0.04 to 0.59, pâ¯=â¯0.03). There was no difference in infection (RR 0.95, 95% CI 0.79 to 1.19, pâ¯=â¯0.44). Trial Sequential Analysis suggests that the required participant numbers to detect or reject a clinically important effect of iron therapy on transfusion requirements or infection in ICU patients has not yet been reached.CONCLUSION:
Iron therapy results in a modest increase in Hb. The current evidence is inadequate to exclude an important effect on transfusion requirements or infection.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Transfusión de Eritrocitos
/
Hematínicos
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Anemia
/
Hierro
Tipo de estudio:
Clinical_trials
/
Systematic_reviews
Límite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
J Crit Care
Asunto de la revista:
TERAPIA INTENSIVA
Año:
2019
Tipo del documento:
Article