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AnemiaCIPATNCT06012760

The Effect of Combined Iron Protocols on Perioperative Allogeneic Transfusion

A study testing Iron sucrose, Human Erythropoietin Injection, Vitamin C and Standard Medical Care in people with Anemia and Iron Deficiency Anemia, run by Second Affiliated Hospital, Zhejiang University, School of Medicine at 1 site in China.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The goal of this clinical trial is to learn if a combined iron supplementation regimen can reduce the need for blood transfusions in adults with iron-deficiency anemia undergoing major elective cardiac surgery. The trial will also look at whether this regimen is safe and well tolerated. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Anemia, Iron Deficiency Anemia, Perioperative
What is being tested?
Iron sucrose, Human Erythropoietin Injection, Vitamin C and Standard Medical Care
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
400 participants
Where
1 siteChina
Study dates
4 Jan 2025to 31 Mar 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Participants must be at least 18 years of age.
  • Major cardiac surgery should encompass procedures such as coronary artery bypass grafting (CABG), valve surgery, or a combination of both.
  • Iron deficiency anemia is defined as having a ferritin level below 100 μg/L or a ferritin level below 300 μg/L accompanied by a transferrin saturation below 25%. Additionally, hemoglobin levels should range between 90 and 130 g/L for men or between 90 and 120 g/L for women.
  • The American Society of Anesthesiologists (ASA) classification should fall within Grade 1-3.
  • Prior to participation, the patient or their legal representative must provide informed consent.

Who cannot join

  • Contraindications for the administration of iron sucrose, ascorbic acid, or rHuEPO.
  • Presence of a temperature exceeding 37.5 °C or the utilization of non-prophylactic antibiotics.
  • Individuals with a weight equal to or less than 50kg.
  • Individuals with a family history of haemochromatosis or thalassaemia, or those with a transferrin saturation level exceeding 50% or a documented history of iron overload.
  • Presence of other known haematological disorders such as folic acid or vitamin B12 deficiency, haemolytic anaemia, haemoglobinopathies, iron granulocytic anaemia, G6PD deficiency, etc.
  • Requirement for emergency surgical intervention.
Show all 10Show fewer
  • Severe hepatic or renal impairment, ALT >3 times the upper limit of normal value or AST >3 times the upper limit of normal value, creatinine >1.5 times the upper limit of normal value
  • Pregnant or lactating women
  • history of blood transfusion, intravenous iron or ascorbic acid use within 12 weeks prior to surgery
  • Acute blood loss, gastrointestinal bleeding, etc. in the preoperative period.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

China1 site, 1 recruiting
  • The Second Affiliated Hospital of Zhejiang University anesthesiology department

    Hangzhou, Zhejiang, 310000

    Min Yan, Doctor, 15888210247, zryanmin@zju.edu.cn

    Min Yan, Doctor

    Recruiting

Other trials in China

About this study

Official title: Effect of Iron Sucrose Combined With Human Erythropoietin and Vitamin C on Perioperative Allogeneic Red Blood Cell Infusion in Major Cardiac Surgery

The goal of this clinical trial is to learn if a combined iron supplementation regimen can reduce the need for blood transfusions in adults with iron-deficiency anemia undergoing major elective cardiac surgery. The trial will also look at whether this regimen is safe and well tolerated. The main questions it aims to answer are:

Does the combined regimen lower the amount of allogeneic red blood cell transfusion needed during and after surgery?

Read more

Are there any side effects or safety concerns associated with the regimen?

Researchers will compare the combined iron supplementation (sucrose iron, erythropoietin, and vitamin C) to standard care to see if it helps reduce blood transfusions.

Participants will:

Receive either the combined regimen or standard care before surgery

Undergo major elective cardiac surgery under general anesthesia

Be monitored for blood transfusion needs and recovery up to 90 days after surgery

Read the detailed description
  1. Hypothesis:The combined protocol of preoperative sucrose iron, human erythropoietin, and vitamin C will demonstrate superiority in reducing perioperative allogeneic red blood cell (RBC) transfusion volume compared to standard care in patients with iron deficiency anemia undergoing major cardiac surgery with cardiopulmonary bypass.
  2. Interventions 2.1.Experimental group: Patients in the experimental group will receive a combination therapy consisting of intravenous sucrose iron (200 mg), subcutaneous recombinant human erythropoietin (150 IU/kg), and intravenous vitamin C (2 g), administered once daily for three consecutive days within the week prior to surgery. 2.2.Control group: Routine perioperative management based on clinical judgment, including observation, monitoring, and standard nursing practices.
  3. Primary endpoint: Total volume of allogeneic RBC transfusion (units) from surgery initiation to postoperative day 5.
  4. Stratification in randomization: Stratification factors include types of surgery, preoperative baseline hemoglobin level.
  5. Follow-up time important points include: baseline upon hospital admission, the morning of surgery, postoperative day 1, postoperative day 5, at discharge, 30 ± 7 days after surgery, and 90 ± 7 days after surgery.
  6. All perioperative transfusion decisions will follow standardized restrictive transfusion thresholds. When the patient's hemoglobin concentration falls below the threshold of 70 g/L during surgery or ICU monitoring, or below 70-80 g/L in the general ward, and/or when signs of anemia or hemodynamic instability are present-including shock, severe arrhythmias, respiratory distress, heart rate >120 beats/min, systolic blood pressure (SBP) <80 mmHg, mean arterial pressure (MAP) <55-60 mmHg, or a reduction in SBP or MAP exceeding 25% from baseline-these findings may indicate significant hypovolemia and warrant consideration of transfusion intervention.
Being tested
Iron sucrose, Human Erythropoietin Injection, Vitamin C, Standard Medical Care
Medical subject headings
Anemia, Anemia, Iron-Deficiency

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Iron sucrose, Human Erythropoietin Injection, Vitamin CDrug

    The participants were administered a combined iron supplementation regimen consisting of iron sucrose,Human Erythropoietin Injection, and vitamin C, three times throughout the preoperative week.

  • Standard Medical CareDrug

    Standard Medical Care (SMC) for the treatment of IDA. SMC as determined by the Investigator for the treatment of iron deficiency anemia (IDA).

Study groups in NCT06012760
Study groupRoleWhat they receive
Combined Iron Protocols group(CIP group)ExperimentalPreoperative randomization was conducted, followed by a three-day regimen in the week preceding surgery, involving the administration of intravenous iron sucrose at a dosage of 200 mg per day, vitamin C at a dosage of 2 g per day, and subcutaneous administration of Human Erythropoietin Injection at a dosage of 150 IU per kilogram.
Receives: Drug: Iron sucrose, Human Erythropoietin Injection, Vitamin C
Standard Medical Care group(SMC group)Active comparatorStandard Medical Care (SMC) for the treatment of IDA. SMC as determined by the Investigator for the treatment of iron deficiency anemia (IDA).
Receives: Drug: Standard Medical Care

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Perioperative allogeneic red blood cell transfusion volume

    The volume of allogeneic red blood cell transfusions during the perioperative period.

    Measured: From the initiation of the surgical procedure until five days post-surgery.

Secondary outcomes (9)
  1. The quantity and percentage of allogeneic blood products utilized during the perioperative period.

    This encompasses blood components such as plasma and platelets, erythrocytes.

    Measured: From the initiation of the surgical procedure until until 90± 7 days following the surgical procedure.

  2. The alterations in perioperative haemoglobin levels.

    Haemoglobin levels were assessed at various time intervals.

    Measured: From the point of randomisation until 90± 7 days following the surgical procedure.

  3. The alterations in ferritin levels and TSAT during the perioperative period.

    Ferritin and Transferrin Saturation values were assessed at various time intervals.

    Measured: From the point of randomisation until 90± 7 days following the surgical procedure.

  4. The alterations in reticulocyte levels during the perioperative period.

    Reticulocyte levels were measured at various time intervals.

    Measured: From the point of randomisation until 90± 7 days following the surgical procedure.

  5. The score measuring the quality of life after surgery.

    The findings are presented based on the EQ VAS score (0-100), which reflects the overall self-assessed health status. A higher score indicates a better health status. Additionally, the results are reported using the EQ-5D-3L Effectiveness Index (EQ-5D-3L) values (5-15), where a lower EQ-5D-3L value signifies a better state of health.

    Measured: From the point of randomisation until 90± 7 days following the surgical procedure.

  6. Incidence of perioperative complication within 90 days after major cardiac surgery

    The potential postoperative complications within acute kidney injury (AKI), serious adverse events (SAE), congestive heart failure, respiratory failure, Allergic reaction, Thrombotic and thromboembolic complications and various infections.

    Measured: From the point of randomisation until 90± 7 days following the surgical procedure.

  7. The mortality rate within 30-day and 90-day postoperative period.

    The mortality rate within 30-day and 90-day postoperative period.

    Measured: Within 90± 7 days after surgery

  8. length of stay in hospital

    The time period from admission to the hospital to discharge

    Measured: Within 90± 7 days after surgery

  9. Length of stay in ICU

    The time period from admission to ICU after surgery to move out from ICU to normal ward

    Measured: Within 90± 7 days after surgery

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Aug 2023
  2. Study start4 Jan 2025
  3. Primary completion31 Jan 2028 (estimated)
  4. Study completion31 Mar 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
400 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06012760
Sponsor's protocol ID
A2023519
Acronym
CIPAT
Status last verified
May 2026
First submitted
22 Aug 2023
Last updated
2 Jun 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: Other researchers could email us to ask the data information.

Publications

  • Zeroual N, Blin C, Saour M, David H, Aouinti S, Picot MC, Colson PH, Gaudard P. Restrictive Transfusion Strategy after Cardiac Surgery. Anesthesiology. 2021 Mar 1;134(3):370-380. doi: 10.1097/ALN.0000000000003682.

    PubMed 33475735
  • Fowler AJ, Ahmad T, Abbott TEF, Torrance HD, Wouters PF, De Hert S, Lobo SM, Rasmussen LS, Della Rocca G, Beattie WS, Wijeysundera DN, Pearse RM; International Surgical Outcomes Study Group. Association of preoperative anaemia with postoperative morbidity and mortality: an observational cohort study in low-, middle-, and high-income countries. Br J Anaesth. 2018 Dec;121(6):1227-1235. doi: 10.1016/j.bja.2018.08.026. Epub 2018 Oct 25.

    PubMed 30442249
  • Carson JL, Brittenham GM. How I treat anemia with red blood cell transfusion and iron. Blood. 2023 Aug 31;142(9):777-785. doi: 10.1182/blood.2022018521.

    PubMed 36315909
  • Spahn DR, Schoenrath F, Spahn GH, Seifert B, Stein P, Theusinger OM, Kaserer A, Hegemann I, Hofmann A, Maisano F, Falk V. Effect of ultra-short-term treatment of patients with iron deficiency or anaemia undergoing cardiac surgery: a prospective randomised trial. Lancet. 2019 Jun 1;393(10187):2201-2212. doi: 10.1016/S0140-6736(18)32555-8. Epub 2019 Apr 26.

    PubMed 31036337
  • Attallah N, Osman-Malik Y, Frinak S, Besarab A. Effect of intravenous ascorbic acid in hemodialysis patients with EPO-hyporesponsive anemia and hyperferritinemia. Am J Kidney Dis. 2006 Apr;47(4):644-54. doi: 10.1053/j.ajkd.2005.12.025.

    PubMed 16564942

Questions about this trial

What is this clinical trial studying?

A study testing Iron sucrose, Human Erythropoietin Injection, Vitamin C and Standard Medical Care in people with Anemia and Iron Deficiency Anemia, run by Second Affiliated Hospital, Zhejiang University, School of Medicine at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 2 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Each site lists its own contact: choose the nearest one under Trial locations. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Perioperative allogeneic red blood cell transfusion volume (time frame: From the initiation of the surgical procedure until five days post-surgery.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06012760, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Jun 2026; AzTrials last refreshed its copy on 7 Nov 2026.

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