INTRAVENOUS IRON THERAPY FOR CORRECTION O F POSTOPERATIVE ANEMIA FOLLOWING SPINAL SURGERY IN CHILDREN

Purpose of the study Spinal fusion surgery often leeds to massive blee ding responsible for anemia in the postoperative period. The aim of th is study was to compare the effect of IV iron ill hydroxide sucrose co mplex (Venofer(R) versus oral iron fumarate administration in postoper ative anemia. The efficacy of both treatments was evaluated by compari ng hemoglobin level in the postoperative period. Methods Two groups of sixteen patients, scheduled for anterior and/or posterior spinal fusi on, were compared. Group 1, historical, was treated by supplementation of 10 mg/kg/day oral iron fumarate. Administration was started when h emoglobin level fell below 9 g/100 ml. Group 2 was treated by intraven ous iron sucrose complex using same criteria as in group 1 for startin g administration. The dosage of iron was individually adapted accordin g to a target hemoglobin level of 13 g/100 ml and to the actual lowest hemoglobin level measured. The total iron deficit was calculated with the following formula: total iron deficit (mg) = 0,24 x body weight ( kg) x (target Hb-actualHb)(g/l). The patients were supplemented by 3 m g/kg/day until the calculated iron deficit was compensated. Results Bo th groups were identical regarding age and lowest hemoglobin level rea ched in the postoperative period. Hemoglobin increased by 0.25 g/day i n group 1, and by 0.36 g/day in group 2. In others words, the benefica l effect of IV iron versus oral iron administration was as high as 45 per cent (p = 0.003). Conclusion Intravenous iron therapy as ferric su crose complex is a new and more effective form of iron therapy than or al iron therapy to restore postoperative hemoglobin after spinal surge ry in children.