Nephrology

544 a IV Iron Infusion For Children With Chronic Renal Failure Or On Peritoneal Dialysis

  • IV Iron Infusion For Children With Chronic Renal Failure Or On Peritoneal Dialysis

    Concentration

    1 Ampoule =  2mL of iron polymaltose = 100mg of iron

    50mg of iron per mL

    IV Administration

    INITIAL INFUSION ONLY: Medical staff should be present for the first 15 minutes of infusion. 

    ALL INFUSIONS

    Monitor vital signs 15 minutely for the first 30 minutes of infusion, and continue hourly vital signs for the remainder of the infusion.

    Total dose is added to a 500mL bag of normal saline to a maximal concentration of 5mg/mL.

    Commence infusion at test-dose rate of 40ml/hr for the first 50ml.

    Observations must be made for anaphylactic shock

    Gradually increase rate to 120ml/hr

    Total infusion time is approximately 5 hours

    SMALLER VOLUMES:

    If a smaller volume is used, the first 10% of the total fluid volume is given at a slower rate (test-dose rate) of (0.08 x total volume of infusion).   It is during this time that close observations must be made for anaphylactic shock.  If no reaction occurs, the remainder of the infusion can be given at the increased rate of (0.24 x total volume of infusion).  The total infusion time is approximately 5 hours. 

    Eg: Put Ferrum H into 200ml of normal saline. 

    Give first 20ml at a rate of 16ml/hr (test dose)

    Observe for anaphylactic shock if no reaction occurs the remainder of the infusion can be given at an increased rate of 48ml/hr

    Adverse Reactions

    Anaphylaxis (rare), headache, nausea, vomiting, joint and muscle pain

    Requirements for treatment of anaphylactic shock must be available:

    • Adrenaline: 1M 0.01mg/kg/dose repeated in 20 minutes if necessary may use up to 0.1mg/kg

    Total Dose Concentration

    Based on haemoglobin concentration and body weight.  See table or equation

    Body weight

    Hb 6.0g/dL

    Hb 7.5 g/dL

    Hb 9.0g/dL or above

    kg

    mL

    amp

    mL

    amp

    mL

    amp

     

     

     

     

     

     

     

    5

    3

    1.5

    3

    1.5

    3

    1.5

    10

    6

    3

    6

    3

    5

    2.5

    15

    10

    5

    9

    4.5

    7

    3.5

    20

    13

    6.5

    11

    5.5

    10

    5

    25

    16

    8

    14

    7

    12

    6

    30

    19

    9.5

    17

    8.5

    15

    7.5

    35

    25

    12.5

    23

    11.5

    20

    10

    40

    27

    13.5

    24

    12

    22

    11

    45

    30

    15

    26

    13

    23

    11.5

    50

    32

    16

    28

    14

    24

    12

    55

    34

    17

    30

    15

    26

    13

    60

    36

    18

    32

    16

    27

    13.5

    65

    38

    19

    33

    16.5

    29

    14.5

    70

    40

    20

    35

    17.5

    30

    15

    75

    42

    21

    37

    18.5

    32

    16

    80

    45

    22.5

    39

    19.5

    33

    16.5

    85

    47

    23.5

    41

    20.5

    34

    17

    90

    49

    24.5

    43

    21.5

    36

    18