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A rapid infusion protocol is safe for total dose iron polymaltose: time for change.
MedLine Citation:
PMID:  21040319     Owner:  NLM     Status:  In-Data-Review    
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.
M Garg; G Morrison; A Friedman; A Lau; D Lau; P R Gibson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Internal medicine journal     Volume:  41     ISSN:  1445-5994     ISO Abbreviation:  Intern Med J     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-07-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101092952     Medline TA:  Intern Med J     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  548-54     Citation Subset:  IM    
Copyright Information:
© 2011 The Authors. Internal Medicine Journal © 2011 Royal Australasian College of Physicians.
Department of Gastroenterology and Hepatology, Eastern Health Department of Gastroenterology, Frankston Hospital Pharmacy Directorate, Eastern Health Monash University Department of Medicine, Eastern Health Clinical School, Melbourne, Victoria, Australia.
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