Iron deficiency in the acute-phase reaction after open aortic surgery.
The objective of this study was to quantify the magnitude of iron deficiency in the postoperative period after open aortic surgery. This was a prospective observational study in 55 consecutive patients. Blood samples were obtained on postoperative days 1, 2, 4, 30, and 45, and the parameters determined were the following: iron, transferrin, transferrin saturation index, transferrin-soluble receptor, ferritin, red cell count, hemoglobin, hematocrit, serum C-reactive protein, fibrinogen, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and number of blood units transfused. We performed statistical ANOVA test for repetitive measurements (lower bound) in regard to its basal level. Iron deficiency and its parameters reached the maximum at 48 hours postoperatively (iron: 18.92 g/dL and transferrin saturation index: 11.1%) (P <.05). There was not a complete recovery after 45 days (iron: 51.23 g/dL and transferrin saturation index: 18.0%) (P <.05). A similar evolution was observed in the other measured parameters (red cell count: 3.5 x 106/L.; hemoglobin: 10.4 g/dL; hematocrit: 30.7%) (P <.005), none affecting the values of concentration or volume (P <.05). Transferrin-soluble receptors, normal at first, were increased at postoperative days 30 and 45 (2.7 and 2.4 mg/dL respectively, P <.005). After open aortic surgery there is an important acute-phase reaction, a dramatic iron deficiency, and a lack of its transporters until the 45th analyzed day. The elevation of transferrin-soluble receptors in the 4th and 6th weeks denotes a necessity of iron supplementation for a correct development of the immature hematic cells since blood parameters do not reach normal levels in the 6th postoperative week.
Solis
J V
JV
Angiology and Vascular Surgery Department, Hospital General Universitario "Gregorio Marañón," Madrid, Spain. jsolisg.hgugm@salud.madrid.org
Portero
J L
JL
Diaz
J
J
Garcia
R
R
Ligero
J M
JM
Vazquez
E
E
Lodeiro
C
C
Ballesteros
L
L
D000210:Acute-Phase Reaction / Q000097:blood* / Q000209:etiology; D000368:Aged; D000369:Aged, 80 and over; D018798:Anemia, Iron-Deficiency / Q000097:blood* / Q000209:etiology; D001011:Aorta / Q000601:surgery*; D001018:Aortic Diseases / Q000601:surgery*; D002097:C-Reactive Protein / Q000378:metabolism; D004906:Erythrocyte Count; D004909:Erythrocyte Indices; D005293:Ferritins / Q000097:blood; D005340:Fibrinogen / Q000378:metabolism; D006400:Hematocrit; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007501:Iron / Q000097:blood; D000090463:Iron Deficiencies; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D011990:Receptors, Transferrin / Q000097:blood; D012307:Risk Factors; D013997:Time Factors; D014168:Transferrin / Q000378:metabolism; D014656:Vascular Surgical Procedures / Q000009:adverse effects*
D006454:Hemoglobins; D011990:Receptors, Transferrin; D014168:Transferrin; D005340:Fibrinogen; D002097:C-Reactive Protein; D005293:Ferritins; C020622:hemoglobin B; D007501:Iron