ArticleCritical care (London, England)2016
Iron supplementation to treat anaemia in adult critical care patients: a systematic review and meta-analysis.
Article in Critical care (London, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 51 citations in OpenAlex.
- Role of preoperative intravenous iron therapy to correct anemia before major surgery: a systematic review and meta-analysis.Systematic reviews · 2021Pooled it
- Effect of Intravenous Iron Dextran on Kidney Outcomes in Acute Kidney Injury with Iron Deficiency: A Randomized Trial.Kidney360 · 2026Trial
- Patient blood management in general intensive care patients.Intensive care medicine · 2026Review
- Association of Anemia Severity with Distinct Microbial and Inflammatory Signatures in Patients Receiving Vancomycin.Healthcare (Basel, Switzerland) · 2026Article
- Effect of Sepsis on Iron Parameters in a Population with High Prevalence of Malnutrition and Iron Deficiency: A Cross-Sectional Case-Control Pilot Study.Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion · 2021Article
- Role Of Intravenous Iron Over Nonsurgical Transfusions In Major Burns.Annals of burns and fire disasters · 2020Article
- Management and prevention of anemia (acute bleeding excluded) in adult critical care patients.Annals of intensive care · 2020Review
- Post-operative of bleeding, haemolysis and coagulation in mechanical circulatory support patients.Annals of translational medicine · 2020Review
- Critical Care Society of Southern Africa adult patient blood management guidelines: 2019 Round-table meeting, CCSSA Congress, Durban, 2018.The Southern African journal of critical care : the official journal of the Critical Care Society · 2020Article
- RBC Transfusion Strategies in the ICU: A Concise Review.Critical care medicine · 2019Review
- Anaemia and transfusion triggers in critically ill patients - What we have learnt thus far.Journal of the Intensive Care Society · 2019Article
- Physiology of Oxygen Transport and its Determinants in Intensive Care Unit.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2019Article
- Inflammatory anemia-associated parameters are related to 28-day mortality in patients with sepsis admitted to the ICU: a preliminary observational study.Annals of intensive care · 2019Article
- Lactate Clearance Predicts Good Neurological Outcomes in Cardiac Arrest Patients Treated with Extracorporeal Cardiopulmonary Resuscitation.Journal of clinical medicine · 2019Article
- Iron Metabolism: An Emerging Therapeutic Target in Critical Illness.Critical care (London, England) · 2019Review
- Iron metabolism in critically ill patients developing anemia of inflammation: a case control study.Annals of intensive care · 2018Article
- Iron supplementation to treat anaemia in adult critical care patients: a systematic review and meta-analysis.Critical care (London, England) · 2016Article
- Ionic Modulation of Bacterial Virulence and Its Role in Surgical Infection.Surgical infectionsReview
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAnaemia affects 60-80 % of patients admitted to intensive care units (ICUs). Allogeneic red blood cell (RBC) transfusions remain the mainstay of treatment for anaemia but are associated with risks and are costly. Our objective was to assess the efficacy and safety of iron supplementation by any route, in anaemic patients in adult ICUs.
methodsElectronic databases (CENTRAL, MEDLINE, EMBASE) were searched through March 2016 for randomized controlled trials (RCT)s comparing iron by any route with placebo/no iron. Primary outcomes were red blood cell transfusions and mean haemoglobin concentration. Secondary outcomes included mortality, infection, ICU and hospital length of stay, mean difference (MD) in iron biomarkers, health-related quality of life and adverse events.
resultsFive RCTs recruiting 665 patients met the inclusion criteria; intravenous iron was tested in four of the RCTs. There was no difference in allogeneic RBC transfusion requirements (relative risk 0.87, 95 % confidence interval (CI) 0.70 to 1.07, p = 0.18, five trials) or mean number of RBC units transfused (MD -0.45, 95 % CI -1.34 to 0.43, p = 0.32, two trials) in patients receiving or not receiving iron. Similarly, there was no difference between groups in haemoglobin at short-term (up to 10 days) (MD -0.25, 95 % CI -0.79 to 0.28, p = 0.35, three trials) or mid-term follow up (last measured time point in hospital or end of trial) (MD 0.21, 95 % CI -0.13 to 0.55, p = 0.23, three trials). There was no difference in secondary outcomes of mortality, in-hospital infection, or length of stay. Risk of bias was generally low although three trials had high risk of attrition bias; only one trial had low risk of bias across all domains.
conclusionIron supplementation does not reduce RBC transfusion requirements in critically ill adults, but there is considerable heterogeneity between trials in study design, nature of interventions, and outcomes. Well-designed trials are needed to investigate the optimal iron dosing regimens and strategies to identify which patients are most likely to benefit from iron, together with patient-focused outcomes.
trial registrationPROSPERO International prospective register of systematic reviews CRD42015016627 . Registered 2 March 2015.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.