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Iron supplementation for patients undergoing cardiac surgery: a protocol for a systematic review and meta-analysis of
Matthew J Cameron1, Latifa Al Kharusi2, Adam Gosselin2
1Faculty of Medicine (Cameron, Gosselin, Gholipour Baradari, Chirico, Yang), McGill University; Department of Anesthesia (Cameron, Al Kharusi, Yang), McGill University; Department of Anesthesia (Cameron, Yang), Jewish General Hospital; McGill University Health Centre Medical Libraries (Amar-Zifkin), Montréal, Que. matthew.cameron@mcgill.ca.
Insights
This study protocol outlines a systematic review on perioperative iron administration in cardiac surgery patients. It aims to assess iron
Area of Science:
- Cardiovascular Surgery
- Hematology
- Evidence-Based Medicine
Background:
- Perioperative iron administration is studied for improving hemoglobin and reducing red blood cell transfusions in cardiac surgery.
- Randomized controlled trials (RCTs) have explored its potential benefits.
- This protocol details a study to evaluate iron's efficacy and safety in this context.
Purpose of the Study:
- To evaluate the efficacy and safety of perioperative iron administration in adult patients undergoing cardiac surgery.
- To determine if iron supplementation should be integrated into enhanced-recovery protocols.
- To inform future research directions in perioperative anemia management.
Main Methods:
- Systematic review and meta-analysis of RCTs.
- Searches will cover MEDLINE, Embase, Cochrane, Web of Science, and Google Scholar up to November 19, 2020.
- Primary outcome: incidence of red blood cell transfusion; secondary outcomes include units transfused, ferritin, reticulocyte count, hemoglobin changes, and adverse events.
Main Results:
- This section will present findings from the systematic review and meta-analysis.
- Results will focus on the primary outcome (red blood cell transfusion incidence) and secondary outcomes.
- Risk of bias will be assessed using the Cochrane Collaboration tool.
Conclusions:
- The study will summarize current evidence on perioperative iron administration in cardiac surgery.
- Findings will guide clinical decision-making regarding enhanced-recovery protocols.
- The review will highlight areas for future research in managing anemia during cardiac surgery.
Background:
Iron administration has been evaluated in several randomized controlled trials for the potential of increasing baseline hemoglobin values and decreasing the incidence of red blood cell transfusion during cardiac surgery. We describe the protocol for a study aiming to evaluate the efficacy and safety of perioperative iron administration in patients undergoing cardiac surgery.
Methods:
We will search MEDLINE, Embase, the Cochrane Central Register of Controlled Trials and the Web of Science, from inception to Nov. 19, 2020, for randomized controlled trials in any language evaluating the perioperative administration of iron in adult patients undergoing cardiac surgery; we will also include the first 50 results from Google Scholar. The primary outcome will be the incidence of red blood cell transfusion from the study intervention time until 8 weeks postoperatively. The secondary outcomes will be the number of red blood cell units transfused; change in ferritin level, reticulocyte count and hemoglobin concentration after iron administration; and adverse events. We will assess the risk of bias with the Cochrane Collaboration Risk of Bias Tool, and will analyze the primary and secondary outcomes using a random-effects model.
Interpretation:
This study will summarize the current evidence about perioperative iron administration in patients undergoing cardiac surgery, help determine whether this intervention should be included in enhanced-recovery protocols, and shape future research if needed. The final manuscript will be submitted to a peer-reviewed journal.
Trial Registration:
PROSPERO no. CRD42020161927.
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