الفهرس 
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Abstract
Iron-deficiency anemia is a global health problem and a common medical condition seen in everyday clinical practice and especially with patients going through cardiac surgery. The most rapid and effective method of correcting anemia is by transfusion of red blood cells. However, blood transfusion itself is not without risk. Treatment of perioperative anemia using iron replacement therapy is, in contrast to blood transfusion, a safe, cheap, and relatively convenient therapy
This study aims to perform a systematic review regarding the effect of preoperative intravenous iron therapy on the need for perioperative blood transfusion and the incidence of major morbidity in anemic patients undergoing cardiac surgery.
The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and articles were identified by searching PubMed, Web of Science, EMBASE, COCHRANE Database of systematic reviews (CDSR), Scopus, and Web of Science. Quality of the studies was assessed using the Cochrane Risk of Bias Tool (ROB-2) and Risk of Bias in Non-randomized Studies tool (ROBANS). The primary outcomes are change in hemoglobin and hematocrit after cardiac surgery and perioperative need for blood transfusion, while secondary outcomes are postoperative length of hospital stay and incidence of major adverse outcomes.
The articles reviewed a total of six randomized controlled trials (RCT) and seven non-randomized observational studies (NRSI) were included in the review. Across studies, 1,732 patients were enrolled. The quality of the RCTs was mostly high, while the quality of the NRSIs was low, primarily due to issues related to blinding of assessors. Two studies showed higher hemoglobin with iron therapy, and only one study showed significant differences in multiple outcomes such as transfusion and morbidity. Hospital stay was reported in 4 studies and averaged 9 days.
Our results showed benefit of preoperative intravenous iron administration in reducing the likelihood of allogeneic blood transfusion and providing a modest increase in hemoglobin concentration in anemic patients undergoing cardiac surgery.