[How is iron prescribed in French ICUs: a practice survey]

To evaluate the practice concerning the iron prescription by French intensivists.

Survey during an intensive care-national congress.

Interviewed practitioners were separated in two groups (prescribing [P] iron once time or more per week; or not [NP] less than one time per month). Iron-treatments (iv or oral) efficacy and tolerance were quoted from 1 to 10.

All the 128 interviewed intensivists (73% male; mean age 36+/-8 years) considered having anaemic patients and 94% considered having patients with iron deficiency. For 72% of them, the iron deficiency was judged frequent (concerning >10% of their patients) and 25% were P. Intravenous iron, oral iron or both were used by, respectively, 20, 35 and 44% of the interviewed intensivists. Intravenous iron was considered more efficient (7+/-2 versus 6+/-2; p<0.001) and better tolerated (7+/-2 versus 6+/-2; p<0.001) than oral iron. There was no demographic difference between P and NP. P answered more often having patients with iron deficiency (p=0.04), but they did not perform biological tests for diagnosis of iron deficiency more often and did not consider iron-treatment efficacy or tolerance higher than NP.

Intensive-care anaemia and iron deficiency were considered to be frequent and iron treatments to be efficient and quite well tolerated. But only 25% of the interviewed intensivists were frequent-iron prescribers. This survey underscore that iron prescription in ICU seems to rely more on clinical feeling than on strong evidence: it's time to investigate!