Intravenous iron infusion

Medical procedure for delivering iron intravenously

Intravenous iron infusion is a medical procedure used to deliver iron directly into the bloodstream through a vein. This method is typically employed when oral iron supplements are ineffective, not tolerated, or when there is a need for rapid replenishment of iron stores.

Indications

Intravenous iron infusions are indicated in several clinical scenarios, including:

• Iron deficiency anemia that is unresponsive to oral iron therapy.
• Patients with chronic kidney disease on hemodialysis, who often require iron supplementation due to blood loss during dialysis and reduced dietary intake.
• Individuals with inflammatory bowel disease (IBD) such as Crohn's disease or ulcerative colitis, where oral iron can exacerbate symptoms.
• Patients undergoing major surgery who are at risk of significant blood loss.
• Pregnant women with severe iron deficiency anemia who cannot tolerate oral iron.

Procedure

The procedure for an intravenous iron infusion involves the following steps:

1. Preparation: The patient is assessed for any history of allergies or reactions to iron products. Vital signs are recorded, and the patient is informed about the procedure.

2. Administration: A healthcare professional inserts an IV catheter into a vein, usually in the arm. The iron solution is then infused over a period of time, which can range from 15 minutes to several hours, depending on the type of iron preparation used.

Intravenous therapy setup

3. Monitoring: The patient is monitored for any adverse reactions during and after the infusion. Common side effects include headache, nausea, and dizziness. Rarely, more severe reactions such as anaphylaxis can occur.

4. Post-infusion care: After the infusion, the IV catheter is removed, and the patient is observed for a short period to ensure there are no delayed reactions.

Types of Intravenous Iron

Several formulations of intravenous iron are available, each with different properties and indications:

• Iron sucrose: Often used in patients with chronic kidney disease.
• Ferric carboxymaltose: Allows for larger doses to be administered in a single session.
• Iron dextran: Requires a test dose due to a higher risk of allergic reactions.
• Ferric gluconate: Commonly used in dialysis patients.

Advantages and Disadvantages

Advantages

• Rapid replenishment of iron stores compared to oral iron.
• Bypasses gastrointestinal absorption issues, making it suitable for patients with malabsorption syndromes.
• Can be used in patients who cannot tolerate oral iron due to gastrointestinal side effects.

Disadvantages

• Requires administration in a healthcare setting.
• Risk of allergic reactions, although rare.
• More expensive than oral iron supplements.

Complications

While generally safe, intravenous iron infusions can have complications, including:

• Allergic reactions: Ranging from mild rashes to severe anaphylaxis.
• Hypotension: A drop in blood pressure during the infusion.
• Iron overload: Rare, but can occur with repeated infusions without proper monitoring.

Related pages

• Anemia
• Iron deficiency
• Hemoglobin
• Blood transfusion

Aqueous ferric thiocyanate solution