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A rapid infusion protocol is safe for total dose iron polymaltose: time for change
Author(s) -
Garg M.,
Morrison G.,
Friedman A.,
Lau A.,
Lau D.,
Gibson P. R.
Publication year - 2011
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/j.1445-5994.2010.02356.x
Subject(s) - medicine , adverse effect , iron deficiency , loading dose , anesthesia , surgery , gastroenterology , anemia
Background: Intravenous correction of iron deficiency by total dose iron polymaltose is inexpensive and safe, but current protocols entail prolonged administration over more than 4 h. This results in reduced patient acceptance, and hospital resource strain. We aimed to assess prospectively the safety of a rapid intravenous protocol and compare this with historical controls. Methods: Consecutive patients in whom intravenous iron replacement was indicated were invited to have up to 1.5 g iron polymaltose by a 58‐min infusion protocol after an initial 15‐min test dose without pre‐medication. Infusion‐related adverse events (AE) and delayed AE over the ensuing 5 days were also prospectively documented and graded as mild, moderate or severe. Results: One hundred patients, 63 female, mean age 54 (range 18–85) years were studied. Thirty‐four infusion‐related AE to iron polymaltose occurred in a total of 24 patients – 25 mild, 8 moderate and 1 severe; higher than previously reported for a slow protocol iron infusion. Thirty‐one delayed AE occurred in 26 patients – 26 mild, 3 moderate and 2 severe; similar to previously reported. All but five patients reported they would prefer iron replacement through the rapid protocol again. The presence of inflammatory bowel disease (IBD) predicted infusion‐related reactions (54% vs 14% without IBD, P < 0.001) and the serum C‐reactive protein was higher in those with reactions ( P = 0.043). Conclusion: Iron polymaltose can be successfully administered using a rapid total dose infusion protocol and was well accepted by patients. It offers significant cost, resource utilization and time benefits for the patient and hospital system.