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Intravenous iron administration and management of adverse events: a systematic review and Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis consensus recommendations.

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Τίτλος: Intravenous iron administration and management of adverse events: a systematic review and Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis consensus recommendations.
Συγγραφείς: Saal-Bauernschubert L; University Hospital Würzburg, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Würzburg, Germany., Kranke P; University Hospital Würzburg, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Würzburg, Germany., Lasocki S; Department of Anesthesiology and Critical Care Medicine, CHU d' Angers, Angers, France; Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis (NATA), Brussels, Belgium., Froessler B; Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis (NATA), Brussels, Belgium; Department of Anaesthesia, Lyell McEwin Hospital, Adelaide, SA, Australia., Mahečić TT; Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis (NATA), Brussels, Belgium; Department of Anesthesiology and Intensive Care, University Clinical Hospital Center Zagreb, Zagreb, Croatia., Baikady RR; Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis (NATA), Brussels, Belgium; Department of Anaesthesia and Perioperative Medicine, The Royal Marsden NHS Foundation Trust, London, UK., Meybohm P; University Hospital Würzburg, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Würzburg, Germany; Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis (NATA), Brussels, Belgium. Electronic address: meybohm_p@ukw.de.
Πηγή: British journal of anaesthesia [Br J Anaesth] 2026 Sep; Vol. 137 (3), pp. 708-720. Date of Electronic Publication: 2026 Jul 01.
Τύπος έκδοσης: Journal Article; Systematic Review
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Elsevier Country of Publication: England NLM ID: 0372541 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1471-6771 (Electronic) Linking ISSN: 00070912 NLM ISO Abbreviation: Br J Anaesth Subsets: MEDLINE
Imprint Name(s): Publication: 2018- : [London] : Elsevier
Original Publication: London, Eng. [etc.]
Ιατρικοί όροι (MeSH): Anemia, Iron-Deficiency*/drug therapy , Iron*/adverse effects , Iron*/administration & dosage , Consensus Statements as Topic*, Hemostasis/drug effects ; Thrombosis/chemically induced ; Thrombosis/therapy ; Humans ; Administration, Intravenous
Περίληψη: Intravenous iron therapy is an established component in the management of iron deficiency and iron-deficiency anaemia. However, it is often underused, often because of the fear of potential adverse events. Therefore, its use necessitates rigorous and systematic evaluation of safety considerations. This NATA (Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis) consensus recommendation summarises current evidence on the most relevant adverse events associated with i.v. iron administration, including hypersensitivity and infusion reactions, hypophosphataemia, extravasation and potential infection risk. Based on the available evidence, we provide practical recommendations for adverse events diagnosis, risk mitigation, patient counselling, and formulation selection to optimise the safe and effective use of i.v. iron for treatment and prevention of anaemia in routine clinical practice.
(Copyright © 2026 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Competing Interests: Declarations of interest LSB declares no conflict of interest. PK is past chairman of the Guidelines Committee of the European Society of Anaesthesiology and Intensive Care (ESAIC). He is a member of the consensus panel that has published the SAMBA/ASER recommendations to predict, prevent and treat postoperative nausea and vomiting. PK has received consultation fees from TEVA Ratiopharm, Sintetica, Baxter, Amicus Clinical Development, BBraun. PK has received compensation to give lectures and perform educational activities for Fresenius Kabi, CSL Vifor, Senzyme, Grünenthal, CSL Behring, Pharmacosmos, Baxter, Pajunk, Livanova, Norgine, Werfen. SL received honoraria for scientific lectures from CSL Vifor, Pharmacosmos, Pfizer and Pierre Fabre outside the present work. SL is the chair of the Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis (NATA). BF has received financial support to give lectures, and attend scientific advisory boards for Vifor Pharma Ltd., Switzerland, Compai Pharma, Malaysia, and Pfizer Australia. TTM is a member of the Executive Committee and the Board of Directors of NATA (the Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis), Co-chair of the ISTH (International Society on Thrombosis and Haemostasis) Subcommittee on Perioperative and Critical Care Thrombosis and Hemostasis, and a member of the ESAIC Scientific Committee as Chair for Intensive Care within Scientific Forum 4 of ESAIC. RRB received Education or research grants and honorarium from Pharmacosoms UK, Hemonetics UK, Vifor Pharma, J&J. PM’s department has received research grants from the German Research Foundation (Bonn, Germany; ME 3559/1-1, ME 3559/3-1, ME 6094/3-2), and BMBF (Berlin, Germany; 01KG1815), BMG (Berlin, Germany; ZMVI1-2520DAT10E, ZMII2-2523FEP50A). PM has received honoraria for scientific lectures from CSL Behring GmbH (Hattersheim, Germany), Pharmacosmos GmbH (Wiesbaden, Germany), CSL Vifor GmbH (Munich, Germany). PM is a member of the Board of Directors of the Foundation for Health, Patient Safety and Patient Blood Management (PBM Foundation), Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis (NATA) and a member of the Working Group of the Scientific Advisory Board Cross-sectional Guidelines for Therapy with Blood Components and Plasma Derivatives.
Contributed Indexing: Keywords: anaemia; anaphylaxis; extravasation; hypersensitivity reaction; hypophosphataemia; intravenous iron
Substance Nomenclature: E1UOL152H7 (Iron)
Entry Date(s): Date Created: 20260630 Date Completed: 20260821 Latest Revision: 20260826
Update Code: 20260826
DOI: 10.1016/j.bja.2026.04.073
PMID: 42379899
Βάση Δεδομένων: MEDLINE
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  Data: Intravenous iron administration and management of adverse events: a systematic review and Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis consensus recommendations.
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  Data: <searchLink fieldCode="AU" term="%22Saal-Bauernschubert+L%22">Saal-Bauernschubert L</searchLink>; University Hospital Würzburg, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Würzburg, Germany.<br /><searchLink fieldCode="AU" term="%22Kranke+P%22">Kranke P</searchLink>; University Hospital Würzburg, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Würzburg, Germany.<br /><searchLink fieldCode="AU" term="%22Lasocki+S%22">Lasocki S</searchLink>; Department of Anesthesiology and Critical Care Medicine, CHU d' Angers, Angers, France; Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis (NATA), Brussels, Belgium.<br /><searchLink fieldCode="AU" term="%22Froessler+B%22">Froessler B</searchLink>; Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis (NATA), Brussels, Belgium; Department of Anaesthesia, Lyell McEwin Hospital, Adelaide, SA, Australia.<br /><searchLink fieldCode="AU" term="%22Mahečić+TT%22">Mahečić TT</searchLink>; Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis (NATA), Brussels, Belgium; Department of Anesthesiology and Intensive Care, University Clinical Hospital Center Zagreb, Zagreb, Croatia.<br /><searchLink fieldCode="AU" term="%22Baikady+RR%22">Baikady RR</searchLink>; Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis (NATA), Brussels, Belgium; Department of Anaesthesia and Perioperative Medicine, The Royal Marsden NHS Foundation Trust, London, UK.<br /><searchLink fieldCode="AU" term="%22Meybohm+P%22">Meybohm P</searchLink>; University Hospital Würzburg, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Würzburg, Germany; Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis (NATA), Brussels, Belgium. Electronic address: meybohm_p@ukw.de.
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  Data: <searchLink fieldCode="JN" term="%220372541%22">British journal of anaesthesia</searchLink> [Br J Anaesth] 2026 Sep; Vol. 137 (3), pp. 708-720. <i>Date of Electronic Publication: </i>2026 Jul 01.
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  Data: Intravenous iron therapy is an established component in the management of iron deficiency and iron-deficiency anaemia. However, it is often underused, often because of the fear of potential adverse events. Therefore, its use necessitates rigorous and systematic evaluation of safety considerations. This NATA (Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis) consensus recommendation summarises current evidence on the most relevant adverse events associated with i.v. iron administration, including hypersensitivity and infusion reactions, hypophosphataemia, extravasation and potential infection risk. Based on the available evidence, we provide practical recommendations for adverse events diagnosis, risk mitigation, patient counselling, and formulation selection to optimise the safe and effective use of i.v. iron for treatment and prevention of anaemia in routine clinical practice.<br /> (Copyright © 2026 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
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  Data: Declarations of interest LSB declares no conflict of interest. PK is past chairman of the Guidelines Committee of the European Society of Anaesthesiology and Intensive Care (ESAIC). He is a member of the consensus panel that has published the SAMBA/ASER recommendations to predict, prevent and treat postoperative nausea and vomiting. PK has received consultation fees from TEVA Ratiopharm, Sintetica, Baxter, Amicus Clinical Development, BBraun. PK has received compensation to give lectures and perform educational activities for Fresenius Kabi, CSL Vifor, Senzyme, Grünenthal, CSL Behring, Pharmacosmos, Baxter, Pajunk, Livanova, Norgine, Werfen. SL received honoraria for scientific lectures from CSL Vifor, Pharmacosmos, Pfizer and Pierre Fabre outside the present work. SL is the chair of the Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis (NATA). BF has received financial support to give lectures, and attend scientific advisory boards for Vifor Pharma Ltd., Switzerland, Compai Pharma, Malaysia, and Pfizer Australia. TTM is a member of the Executive Committee and the Board of Directors of NATA (the Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis), Co-chair of the ISTH (International Society on Thrombosis and Haemostasis) Subcommittee on Perioperative and Critical Care Thrombosis and Hemostasis, and a member of the ESAIC Scientific Committee as Chair for Intensive Care within Scientific Forum 4 of ESAIC. RRB received Education or research grants and honorarium from Pharmacosoms UK, Hemonetics UK, Vifor Pharma, J&J. PM’s department has received research grants from the German Research Foundation (Bonn, Germany; ME 3559/1-1, ME 3559/3-1, ME 6094/3-2), and BMBF (Berlin, Germany; 01KG1815), BMG (Berlin, Germany; ZMVI1-2520DAT10E, ZMII2-2523FEP50A). PM has received honoraria for scientific lectures from CSL Behring GmbH (Hattersheim, Germany), Pharmacosmos GmbH (Wiesbaden, Germany), CSL Vifor GmbH (Munich, Germany). PM is a member of the Board of Directors of the Foundation for Health, Patient Safety and Patient Blood Management (PBM Foundation), Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis (NATA) and a member of the Working Group of the Scientific Advisory Board Cross-sectional Guidelines for Therapy with Blood Components and Plasma Derivatives.
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        Type: general
      – SubjectFull: Thrombosis chemically induced
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