Does IV Iron Increase Anaerobic Threshold in Iron Deficiency Anaemia?
Research type
Research Study
Full title
Does Intravenous Iron Therapy Increase The Anaerobic Threshold Of Iron Deficiency Anaemia Patients Undergoing Surgery For Colorectal Cancer?
IRAS ID
177154
Contact name
Daniel Bell
Contact email
Sponsor organisation
Mid Essex Hospital Services NHS Trust
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
Preoperative anaemia is a common problem in patients with bowel cancer presenting for curative surgery. Anaemia in these patients has been associated with higher mortality and morbidity, as well as longer critical care and hospital length of stay. Therefore, patients identified as having iron deficiency anaemia preoperatively are increasingly being given intravenous iron therapy to increase their haemoglobin concentration. The alternative to this is a blood transfusion, with risks such as transfusion reactions, higher rates of wound infections and also cancer recurrence following surgery.
Cardiopulmonary exercise testing (CPET) is in essence an exercise test on a stationary bike with the patient attached to non-invasive monitors. This is performed in the hospital pre-assessment clinic as an outpatient. On exercise, it is possible to determine when a patient’s metabolism changes from aerobic to anaerobic. The point at which this is occurs generates a number used as a tool to predict perioperative complications and risk stratify patients for appropriate postoperative care setting. The lower the anaerobic threshold, the higher the perioperative risk. This test is now routinely used for all patients undergoing major surgery at our institution. Of the measurements generated, anaerobic threshold and peak oxygen consumption are of particular interest, and in a recent study, transfusion of blood to anaemic patients demonstrated an increase in anaerobic threshold.
As blood transfusions have associated risks, intravenous iron represents an alternative safer therapy. Our department would like to perform a repeat a CPET in adult patients with colorectal cancer after they have been given intravenous iron therapy to determine whether it increases their anaerobic threshold.
We plan to compare critical care and hospital length of stay to our historical dataset of anaemic patients who underwent colorectal cancer resection before institution of IV iron therapy at our hospital.REC name
South Central - Oxford C Research Ethics Committee
REC reference
15/SC/0361
Date of REC Opinion
9 Jun 2015
REC opinion
Favourable Opinion