[Can venous iron and tranexamic acid reduce the transfusion need? Report on a non randomized, case control study].
OBJECTIVE
To evaluate if the association of injectable iron and tranexamic acid allows a significant saving in transfusion, in cases of myomectomies and hysterectomies.


METHODS
This is a prospective, non randomized study done over 8 months (from January 2013 to August 2013). Were included, patients undergoing hysterectomy or myomectomy who had a hemoglobin level greater than or equal to 8g/dl and less than 12g/dl. Two groups were compared: group A consisting of patients for whom a pack red cells was ordered and the group B which patients received intravenous iron preoperatively and tranexamic acid perioperatively. The level of hemoglobin, pre- and postoperative, the average number of blood units per patient and estimated blood loss was compared. The transfusion economy was evaluated.


RESULTS
During this period, 87 patients with a mean age of 40±9 years (range: 23 and 70years) were included according to our criteria: 44 patients in group A and 43 patients in group B. Initial mean hemoglobin in both groups was 9.1±0.7g/dl. In group B, after iron administration, the mean hemoglobin was 11.3±0.7g/dl. The average number of red blood cells received intraoperative patient in group A was 1.54±0.51. The estimated blood loss was significant greater (P=0.0002) in group A (571.6±237.1ml) than in group B (213.7±131.7ml). No transfusion was performed in group B.


CONCLUSIONS
The association intravenous iron and tranexamic acid resulted in the reduction of transfusion requirements in our setting. It could be integrated in the strategy for sparing blood transfusion in scheduled surgery with hemorrhagic risks.
Unité de soins intensifs du centre hospitalier universitaire de Libreville, 7919 Libreville, Gabon. Electronic address: laurenceessola@yahoo.fr.
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Essola
Centre national de transfusion sanguine de Libreville, Gabon.
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Kouégnigan Rérambiah
Unité de soins intensifs du centre hospitalier d'Angondjé, Gabon.
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Obame
Unité de soins intensifs du centre hospitalier universitaire de Libreville, 7919 Libreville, Gabon.
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Issembè
Unité de soins intensifs du centre hospitalier universitaire de Libreville, 7919 Libreville, Gabon.
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Sima Zué
D061605:Administration, Intravenous; D000328:Adult; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D007501:Iron / Q000627:therapeutic use*; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000628:therapy*; D011446:Prospective Studies; D014148:Tranexamic Acid / Q000627:therapeutic use*; D063186:Uterine Myomectomy / Q000009:adverse effects; D055815:Young Adult
D000933:Antifibrinolytic Agents; D006454:Hemoglobins; D014148:Tranexamic Acid; D007501:Iron
Acide tranexamique; Fer intraveineux; Hemoglobin; Hysterectomy; Hystérectomie; Hémoglobine; Myomectomie; Myomectomy; Tranexamic acid; Venous iron