Management of iron deficiency anemia in the pediatric emergency department: Pilot study of red blood cell transfusion versus IV iron therapy

Iron deficiency is the most common nutritional deficiency in the world. Being iron deficient leads to iron deficiency anemia (IDA), which affects children's growth, development and learning. Treatment of chronic IDA includes administering oral iron supplementation. In certain instances, however, the degree of anemia is too severe to use oral iron alone.

When a child presents to the emergency department (ED) with severe IDA, red blood cell (RBC) transfusion is utilized to correct the anemia quickly. Intravenous iron therapy is another viable option but is almost never used. This option would provide the iron needed to correct the anemia without the use of blood products, which have inherent risks.

This pilot study aims to evaluate whether intravenous iron is equivalent to RBC transfusion for the treatment of severe IDA. Children presenting to the ED with severe IDA will be randomized to receive either intravenous iron or RBC transfusion. The study outcomes will incldue comparison of hemoglobin, mean corpuscular volume (MCV), reticulocyte count, ferritin, iron, and total iron binding capacity at 3, 6, 9 and 12 weeks, between the two treatment groups; as well as signs and symptoms, transfusion rates and adverse event rates.

LIEBMAN, Mira

Children's Hospital of Eastern Ontario

Blood Efficiency Accelerator Program

Ontario

$29,831