Table 1 Characteristics of included studies
Study | Design | Type of surgery | Inclusion criteria | Group (N) | IV iron time and dose | Other agents | Mean age (years) | Trigger for transfusion | NOS selection/comparability/outcome |
|---|---|---|---|---|---|---|---|---|---|
Yoo 2011 (Korea) | RCT single-site single-blinded | Valve surgery | WHO anemia criteria | IV iron (37) | 1 day before surgery 200 mg | 500U/kg EPO | 56 ± 12 | Hb < 70 g/L during CPB or Hb < 80 g/L after CPB and postoperatively | / |
Control (37) | Saline |  | 59 ± 12 | ||||||
Urena 2017 (Canada) | RCT double-blind | Valve surgery or TAVI | WHO anemia criteria | IV iron (48) | 10(± 4) and 1(± 1) days before surgery 200 mg each time | 0.75 ug/kg EPO each time | 81 ± 7 | Hb ≤ 70 g/L or haematocrit less than 22% | / |
Control (52) | Saline | 81 ± 7 | |||||||
Padmanabhan 2019 (UK) | RCT single-centrenon-blinded | CABG or open valve surgery | WHO anemia criteria | IV iron (20) | 3–8 weeks before surgery 1000 mg | None | 73 ± 12 | Not mentioned | / |
Control (20) | Oral iron |  | 75 ± 10 | ||||||
Spahn 2019 (Switzerland) | RCT single-centre double-blind | CABG and/or valve surgery | WHO anemia criteria or iron deficiency | IV iron (243) | The day before surgery 20 mg/kg (Max 1000 mg) | 40,000U EPO + 1 mg VB12 + 5 mg FA | 69 ± 11 | Hb < 70-80 g/L intraoperatively and in intensive care or Hb < 80 g/L on the regular ward | / |
Control (241) | Placebo | 67 ± 12 | |||||||
Kong 2022 (UK) | RCT single-centre open-label | CABG and/or valve surgery | Hb: 100-130 g/L with iron deficiency | IV iron (79) | 2–10 weeks before surgery 20 mg/kg (Max 1000 mg) | 200ug EPO | 74 ± 9 | Hb ≤ 70 g/L | / |
Control (77) | Oral iron |  | 73 ± 7 | ||||||
Shokri 2022 (Egypt) | RCT double-blind | CABG | WHO anemia criteria | IV iron (40) | 7 days before surgery 1000 mg | None | 58.3 ± 4.4 | Not mentioned | / |
Control (40) | Saline |  | 60.1 ± 4.8 | ||||||
Cladellas 2012 (Spain) | Prospective cohort study | Cardiac surgery | WHO anemia criteria | IV iron (75) | 1 month before surgery Max 200 mg each time (five times in total) | 500 IU/kg EPO each time | 73 ± 10 | Hb < 70 g/L | 3/1/3 |
Observation (59) | No treatment |  | 71 ± 8 |  | |||||
Klein 2020 (UK) | Retrospective multicentre observational study | CABG and/or valve surgery | WHO anemia criteria | IV iron (64) | At least 10 days before surgery 20 mg/kg (Max1000mg) | None | 70.2 ± 10.9 | Not mentioned | 4/1/3 |
Observation (72) | No treatment |  | 69.3 ± 11.8 | ||||||
Evans 2021 (UK) | Retrospective observational study | CABG and/or valve surgery | Hb < 130 g/L | IV iron (75) | Before surgery 20 mg/kg | None | 71 ± 11 | Hb < 80 g/L | 4/1/3 |
Observation (72) | No treatment |  | 72 ± 8 | ||||||
Peel 2021 (Canada) | Retrospective cohort study | CABG and/or valve surgery | Hb < 130 g/L | IV iron (84) | Before surgery < 300 mg; 300-600 mg; > 600 mg | None | 68 ± 13 | Not mentioned | 3/1/3 |
Observation (78) | No treatment |  | 68 ± 10 | ||||||
Quarterman 2021 (UK) | Retrospective observational study | CABG and/or valve surgery | Hb < 130 g/L | IV iron (190) | 2 weeks before surgery 20 mg/kg | None | 70.30 ± 10.46 | Not mentioned | 4/1/3 |
Observation (581) | No treatment |  | 72.65 ± 8.17 |