Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2007 Jan;89(1):44-6.
doi: 10.1308/003588407X160837.

Iron supplementation for postoperative anaemia following major paediatric orthopaedic surgery

Kelvin K W Lau  1 , Murali M Utukuri, Manoj Ramachandran, David H A Jones
Affiliations
Multicenter Study

Iron supplementation for postoperative anaemia following major paediatric orthopaedic surgery

Kelvin K W Lau et al. Ann R Coll Surg Engl. 2007 Jan.

Abstract

Introduction: There is increasing evidence that the anaemia of surgery is not iron deficient and is, therefore, unresponsive to iron supplementation. Oral iron is best avoided postoperatively, particularly in children, due to its dose-dependent side effects. We undertook a national survey of major paediatric orthopaedic surgical units in the UK to investigate the current management of postoperative anaemia with particular reference to iron supplementation.

Materials and methods: Middle-grade doctors and charge nurses at 23 major paediatric orthopaedic units in the UK were contacted by telephone and a structured questionnaire was used to determine the management of postoperative anaemia in major hip, pelvic and spinal surgery.

Results: Only one (4.3%) of the units surveyed had a formally established protocol for the management of postoperative anaemia. Only 10 out of 23 units (43.5%) did not routinely prescribe iron postoperatively. Of the remaining units, 11 commenced iron based on the postoperative haemoglobin level while only 2 used iron supplementation after investigation of serum haematinics for iron deficiency. One unit used erythropoietin in the treatment of postoperative anaemia.

Conclusions: Iron supplementation continues to be used in major paediatric orthopaedic surgery in the treatment of postoperative anaemia in the absence of iron deficiency. Given the current available evidence, we call for an end to the practice of routine iron supplementation for postoperative anaemia following major paediatric orthopaedic surgery in the UK.

PubMed Disclaimer

Figures

Figure 1
Figure 1
The use of iron supplementation varies widely between different paediatric orthopaedic units in the UK
See this image and copyright information in PMC

References

    1. Mercuriali F, Inghilleri G. Transfusion risks and limitations. Minerva Anestesiol. 1999;65:286–92. - PubMed
    1. Goodnough LT, Shander A, Spence R. Bloodless medicine: clinical care without allogeneic blood transfusion. Transfusion. 2003;43:668–76. - PubMed
    1. Zauber NP, Zauber AG, Gordon FJ, Tillis AC, Leeds HC, Berman E, et al. Iron supplementation after femoral head replacement for patients with normal iron stores. JAMA. 1992;267:525–7. - PubMed
    1. Sutton PM, Cresswell T, Livesey JP, Speed K, Bagga T. Treatment of anaemia after joint replacement. A double-blind, randomised, controlled trial of ferrous sulphate versus placebo. J Bone Joint Surg Br. 2004;86:31–3. - PubMed
    1. Rohling RG, Zimmerman AP, Breymann C. Intravenous versus oral iron supplementation for preoperative stimulation of hemoglobin synthesis using recombinant human erythropoietin. J Hematother Stem Cell Res. 2000;9:497–500. - PubMed

Publication types