Definition of functional iron deficiency and intravenous iron supplementation

In a prospective, open-label, randomised controlled trial, 1 Khalafallah AA Yan C Al-Badri R et al. Intravenous ferric carboxymaltose versus standard care in the management of postoperative anaemia: a prospective, open-label, randomised controlled trial. Lancet Haematol. 2016; 3: e415-e425 Summary Full Text Full Text PDF Scopus (104) Google Scholar Alhossain Khalafallah and colleagues showed that intravenous ferric carboxymaltose is a feasible approach to treat functional iron deficiency in the postoperative phase. The authors show that ferric carboxymaltose decreases need for transfusion, duration of hospital stay, and infection rate, probably by bypassing the hepcidin-mediated blockade of iron utilisation that exists due to postoperative inflammation in case of functional iron deficiency. Intravenous ferric carboxymaltose versus standard care in the management of postoperative anaemia: a prospective, open-label, randomised controlled trialPostoperative intravenous ferric carboxymaltose is a feasible and pragmatic management approach in surgical patients with functional iron deficiency anaemia. Our study suggests that patient blood management guidelines should be updated, incorporating the use of postoperative intravenous iron infusion to optimise patient outcomes. Further trials to assess our approach are warranted. Full-Text PDF Definition of functional iron deficiency and intravenous iron supplementation – Author's replyIron-restricted erythropoiesis occurs in cases of both absolute and functional iron deficiency. The latter setting represents a state of iron-restricted erythropoiesis characterised by an imbalance between iron demand and serum iron that is readily available for effective erythropoiesis.1 Anaemia associated with chronic disease is usually diagnosed in the absence of iron deficiency and other known causes. Assessment of serum ferritin levels can allow the distinction between absolute iron deficiency and inflammatory iron sequestration. Full-Text PDF