{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T04:53:25Z","timestamp":1777524805365,"version":"3.51.4"},"reference-count":30,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2019,10,13]],"date-time":"2019-10-13T00:00:00Z","timestamp":1570924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005006","name":"Asan Institute for Life Sciences, Asan Medical Center","doi-asserted-by":"publisher","award":["2016-1198"],"award-info":[{"award-number":["2016-1198"]}],"id":[{"id":"10.13039\/501100005006","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>This study assessed the efficacy of intraoperative high-dose intravenous iron therapy in facilitating recovery from postoperative anemia and reducing the transfusion rate in patients with total knee and total hip arthroplasty. This prospective randomized controlled study involved 58 subjects. Group F received 1000 mg intravenous ferric carboxymaltose and Group C received normal saline. The changes in hemoglobin (Hb), hematocrit, iron metabolism variables, transfusion rates, and the arterial partial pressure of oxygen and the fraction of oxygen (PaO2\/FiO2) ratio were recorded. There were 29 patients of each group. The change in Hb levels from baseline to 1 month post-surgery was higher in Group F than in Group C (0.3 \u00b1 1.0 g\/dl vs. \u22120.8 \u00b1 0.8 g\/dl, p &lt; 0.001). Functional iron deficiency occurred more frequently in Group C (0% vs. 48.3%, p &lt; 0.001) after the operation. The incidence of postoperative anemia, transfusion rate and P\/F ratio did not significantly differ between the two groups. This study suggests that intraoperative high-dose ferric carboxymaltose during lower limb total arthroplasty can facilitate the recovery from postoperative anemia. Although it could not prevent the occurrence of postoperative anemia or the administration of transfusion, this treatment seemed to overcome surgery-related decrease of iron availability.<\/jats:p>","DOI":"10.3390\/jcm8101674","type":"journal-article","created":{"date-parts":[[2019,10,14]],"date-time":"2019-10-14T03:54:13Z","timestamp":1571025253000},"page":"1674","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["The Effect of Intraoperative Ferric Carboxymaltose in Joint Arthroplasty Patients: A Randomized Trial"],"prefix":"10.3390","volume":"8","author":[{"given":"Hee-Sun","family":"Park","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic road 43-gil, Songpa-gu, Seoul 05505, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0806-8969","authenticated-orcid":false,"given":"Tae-Yop","family":"Kim","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology and Pain Medicine, Konkuk University Medical Center, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ha-Jung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic road 43-gil, Songpa-gu, Seoul 05505, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young-Jin","family":"Ro","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic road 43-gil, Songpa-gu, Seoul 05505, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hwa-Young","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic road 43-gil, Songpa-gu, Seoul 05505, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4881-1884","authenticated-orcid":false,"given":"Won Uk","family":"Koh","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic road 43-gil, Songpa-gu, Seoul 05505, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,10,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1046\/j.1537-2995.1998.381098440857.x","article-title":"Prospective validation of a point score system for predicting blood transfusion following hip or knee replacement","volume":"38","author":"Larocque","year":"1998","journal-title":"Transfusion"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2684","DOI":"10.1016\/j.arth.2017.04.048","article-title":"Incidence and risk factors for blood transfusion in total joint arthroplasty: Analysis of a statewide database","volume":"32","author":"Slover","year":"2017","journal-title":"J. Arthroplast."},{"key":"ref_3","first-page":"E12","article-title":"Incidence, risk factors, and outcome trends of acute kidney injury in elective total hip and knee arthroplasty","volume":"45","author":"Nadkarni","year":"2016","journal-title":"Am. J. Orthop. (Belle Mead NJ)"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3406","DOI":"10.1182\/blood-2008-10-167643","article-title":"Transfusion-related mortality: The ongoing risks of allogeneic blood transfusion and the available strategies for their prevention","volume":"113","author":"Vamvakas","year":"2009","journal-title":"Blood"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1093\/bja\/aes135","article-title":"Effect of a patient blood management programme on preoperative anaemia, transfusion rate, and outcome after primary hip or knee arthroplasty: A quality improvement cycle","volume":"108","author":"Kotze","year":"2012","journal-title":"Br. J. Anaesth."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2688","DOI":"10.1016\/j.arth.2017.04.029","article-title":"Is there a role for preoperative iron supplementation in patients preparing for a total hip or total knee arthroplasty?","volume":"32","author":"Petis","year":"2017","journal-title":"J. Arthroplast."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.ijsu.2006.02.003","article-title":"Preoperative haematinics and transfusion protocol reduce the need for transfusion after total knee replacement","volume":"5","author":"Cuenca","year":"2007","journal-title":"Int. J. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1111\/j.1365-3148.2009.00908.x","article-title":"An individualized pre-operative blood saving protocol can increase pre-operative haemoglobin levels and reduce the need for transfusion in elective total hip or knee arthroplasty","volume":"19","author":"Colado","year":"2009","journal-title":"Transfus. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1111\/trf.13468","article-title":"Implementing a blood management protocol during the entire perioperative period allows a reduction in transfusion rate in major orthopedic surgery: A before-after study","volume":"56","author":"Rineau","year":"2016","journal-title":"Transfusion"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1463","DOI":"10.1016\/j.arth.2013.01.024","article-title":"The use of preoperative erythropoiesis-stimulating agents (ESAs) in patients who underwent knee or hip arthroplasty: A meta-analysis of randomized clinical trials","volume":"28","author":"Alsaleh","year":"2013","journal-title":"J. Arthroplast."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1111\/trf.12195","article-title":"Very-short-term perioperative intravenous iron administration and postoperative outcome in major orthopedic surgery: A pooled analysis of observational data from 2547 patients","volume":"54","author":"Munoz","year":"2014","journal-title":"Transfusion"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1111\/j.1537-2995.2010.02783.x","article-title":"Effects of intravenous iron combined with low-dose recombinant human erythropoietin on transfusion requirements in iron-deficient patients undergoing bilateral total knee replacement arthroplasty (CME)","volume":"51","author":"Na","year":"2011","journal-title":"Transfusion"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1097\/01.anes.0000291441.10704.82","article-title":"Treatment of iron deficiency anemia in orthopedic surgery with intravenous iron: Efficacy and limits: A prospective study","volume":"107","author":"Theusinger","year":"2007","journal-title":"Anesthesiology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1111\/j.1537-2995.2006.00859.x","article-title":"Perioperative intravenous iron, with or without erythropoietin, plus restrictive transfusion protocol reduce the need for allogeneic blood after knee replacement surgery","volume":"46","author":"Cuenca","year":"2006","journal-title":"Transfusion"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"4666","DOI":"10.3748\/wjg.15.4666","article-title":"Intravenous iron in inflammatory bowel disease","volume":"15","author":"Munoz","year":"2009","journal-title":"World J. Gastroenterol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1111\/j.1365-3148.2006.00682.x","article-title":"Perioperative intravenous iron preserves iron stores and may hasten the recovery from post-operative anaemia after knee replacement surgery","volume":"16","author":"Cuenca","year":"2006","journal-title":"Transfus. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.1016\/j.freeradbiomed.2013.09.001","article-title":"The complex interplay of iron metabolism, reactive oxygen species, and reactive nitrogen species: Insights into the potential of various iron therapies to induce oxidative and nitrosative stress","volume":"65","author":"Weiss","year":"2013","journal-title":"Free Radic. Biol. Med."},{"key":"ref_18","first-page":"8","article-title":"On the role of iron therapy for reducing allogeneic blood transfusion in orthopaedic surgery","volume":"10","author":"Cuenca","year":"2012","journal-title":"Blood Transfus."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1308\/rcsann.2016.0139","article-title":"Impact of a blood management protocol on transfusion rates and outcomes following total hip and knee arthroplasty","volume":"98","author":"Frew","year":"2016","journal-title":"Ann. R. Coll. Surg. Engl."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1007\/s12630-019-01351-6","article-title":"Efficacy and safety of erythropoietin and iron therapy to reduce red blood cell transfusion in surgical patients: A systematic review and meta-analysis","volume":"66","author":"Kei","year":"2019","journal-title":"Can. J. Anesth.\/J. Can. D\u2019anesth."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1001\/jama.1992.03480040073033","article-title":"Iron supplementation after femoral head replacement for patients with normal iron stores","volume":"267","author":"Zauber","year":"1992","journal-title":"JAMA"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1111\/j.1365-2362.1995.tb01718.x","article-title":"Post-operative erythropoiesis is limited by the inflammatory effect of surgery on iron metabolism","volume":"25","author":"Biesma","year":"1995","journal-title":"Eur. J. Clin. Investig."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1053\/j.seminhematol.2018.04.006","article-title":"A prospective randomised controlled trial of a single intravenous infusion of ferric carboxymaltose vs. single intravenous iron polymaltose or daily oral ferrous sulphate in the treatment of iron deficiency anaemia in pregnancy","volume":"55","author":"Khalafallah","year":"2018","journal-title":"Semin. Hematol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.1111\/anae.14358","article-title":"An international consensus statement on the management of postoperative anaemia after major surgical procedures","volume":"73","author":"Munoz","year":"2018","journal-title":"Anaesthesia"},{"key":"ref_25","first-page":"41","article-title":"Iron metabolism and erythropoiesis after surgery","volume":"85","author":"Kraaijenhagen","year":"1998","journal-title":"Br. J. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1111\/j.1423-0410.2007.01014.x","article-title":"Efficacy and safety of intravenous iron therapy as an alternative\/adjunct to allogeneic blood transfusion","volume":"94","author":"Munoz","year":"2008","journal-title":"Vox Sang."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"265","DOI":"10.2106\/JBJS.I.00883","article-title":"Iron supplementation for anemia after hip fracture surgery: A randomized trial of 300 patients","volume":"92","author":"Parker","year":"2010","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1111\/j.1572-0241.2007.01744.x","article-title":"A novel intravenous iron formulation for treatment of anemia in inflammatory bowel disease: The ferric carboxymaltose (FERINJECT) randomized controlled trial","volume":"103","author":"Kulnigg","year":"2008","journal-title":"Am. J. Gastroenterol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1136\/jcp.2010.079046","article-title":"Disorders of iron metabolism. Part 1: Molecular basis of iron homoeostasis","volume":"64","author":"Munoz","year":"2011","journal-title":"J. Clin. Pathol."},{"key":"ref_30","first-page":"301","article-title":"Intravenous iron-dextran: Therapeutic and experimental possibilities","volume":"100","author":"Ganzoni","year":"1970","journal-title":"Schweiz. Med. 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