Oral iron is commonly used in conjunction with EPO preoperatively for hemorrhagic surgeries in children and especially in the surgery of craniosynostosis. The bioavailability of oral iron is low and compliance with treatment is inconsistent. The aim of this study is to evaluate whether the use of ferric carboxymaltose by injection, which has a much better bioavailability, would make it possible to increase the preoperative hemoglobin level more effectively and thus reduce the risk of perioperative blood transfusion .
Prospective study, randomized in two parallel groups (martial treatment versus venous injection) and stratified by center (Montpellier, Nice, Angers). The number of subjects required is 100 patients, or 50 per group.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
100
Young children operated with craniosynostosis and treated with EPO and ferrous fumarate or ferostrane per os or intravenous ferric carboxymaltose.
University Hospital of Angers
Angers, France
University Hospital of Montpellier
Montpellier, France
Variation from reference in hemoglobin rate at the day before surgery
Variation of hemoglobin rate between reference value (collected right before the implementation of treatment) and preoperative hemoglobin rate (collected one day before surgery)
Time frame: Hemoglobin rate change from reference day (right before treatment) to one day before surgery (from 22 days to 5 weeks maximum)
Variation from reference in hemoglobin rate at the day before surgery depending on the reference iron status
Variation of hemoglobin rate between reference value (collected right before the implementation of treatment) and preoperative hemoglobin rate (collected one day before surgery) depending on the reference iron status
Time frame: Reference day (right before treatment) and one day before surgery (from 22 days to 5 weeks maximum)
Variation from reference in hemoglobin rate at the day before surgery depending on the inflammatory state of patient evaluated by CRP rate before treatment
Variation of hemoglobin rate between reference value (collected right before the implementation of treatment) and preoperative hemoglobin rate (collected one day before surgery) depending on the CRP rate before treatment
Time frame: Reference day (right before treatment) and one day before surgery (from 22 days to 5 weeks maximum)
Frequency of EPO treatment discontinuation at the end of 2nd injection
Number of patient stopping EPO injections at the end of 2nd injection
Time frame: 15 days before surgery
Variation from reference in iron status at the day before surgery
Changes in iron status between reference day (right before the implementation of treatment) and preoperative iron status (one day before surgery)
Time frame: Reference day (right before treatment) and one day before surgery (from 22 days to 5 weeks maximum)
Occurrence of adverse events due to experimental treatments
Comparision of adverse event du to experimental treatments (ferric carboxymaltose versus ferrous fumarate)
Time frame: from treatment administration to end of patient follow-up
Compliance of oral iron treatment
Evaluated by visual analogic scale (0 the minimum to 10 the maximum)
Time frame: At the end of oral iron treatment
Rate of blood transfusion in perioperative phase and during 3 days following surgery
Number of transfused patients among all patients
Time frame: Perioperative phase and during 3 days following surgery
Number of packed red blood cells transfused in perioperative phase and during 3 days following
Time frame: Perioperative phase and during 3 days following surgery
Volume of packed red blood cells transfused
Volume in mL/kg
Time frame: Perioperative phase and during 3 days following surgery
Total perioperative blood loss
Expressed in red blood cell mass
Time frame: Perioperative phase and during 3 days following surgery
Cost of oral ferrous fumarate treatment compared to ferric carboxymaltose treatment
Time frame: At the end of patient folllow-up (6 months after surgery)
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