Anemia in the ICU

Prakash, Devina

doi:10.1016/j.ccc.2012.04.012

Cited by 47 publications

(26 citation statements)

References 32 publications

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“…Infection and inflammation induce the anemia of inflammation (AI), which, after iron deficiency anemia, is the most common anemia observed in hospitalized patients. AI is caused by inflammatory responses that impact three areas of erythrocyte production and homeostasis [64][65][66][67][68]. Inflammation leads to iron sequestration that limits iron availability for hemoglobin synthesis [68][69][70].…”

Section: Inflammation Inhibits Steady State Erythropoiesismentioning

confidence: 99%

Stress Erythropoiesis is a Key Inflammatory Response

Paulson

Ruan

et al. 2020

Cells

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Bone marrow medullary erythropoiesis is primarily homeostatic. It produces new erythrocytes at a constant rate, which is balanced by the turnover of senescent erythrocytes by macrophages in the spleen. Despite the enormous capacity of the bone marrow to produce erythrocytes, there are times when it is unable to keep pace with erythroid demand. At these times stress erythropoiesis predominates. Stress erythropoiesis generates a large bolus of new erythrocytes to maintain homeostasis until steady state erythropoiesis can resume. In this review, we outline the mechanistic differences between stress erythropoiesis and steady state erythropoiesis and show that their responses to inflammation are complementary. We propose a new hypothesis that stress erythropoiesis is induced by inflammation and plays a key role in maintaining erythroid homeostasis during inflammatory responses.

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Section: Inflammation Inhibits Steady State Erythropoiesismentioning

confidence: 99%

Stress Erythropoiesis is a Key Inflammatory Response

Paulson

Ruan

et al. 2020

Cells

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“…Another major cause of anemia in critically ill patients is anemia of inflammation (AI) [ 3 ]. Although distinguishing AI from anemia due to iron deficiency is a diagnostic challenge, the contribution of inflammation to the development of anemia is thought to play a role in up to 75% of critically ill patients [ 4 , 5 ]. AI is characterized by a decreased production of red blood cells, a shortened red blood cell life span and alterations in iron metabolism, which will impact erythropoiesis [ 4 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Iron metabolism in critically ill patients developing anemia of inflammation: a case control study

Bos

Binnekade

Nota

et al. 2018

Ann. Intensive Care

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BackgroundAnemia occurring as a result of inflammatory processes (anemia of inflammation, AI) has a high prevalence in critically ill patients. Knowledge on changes in iron metabolism during the course of AI is limited, hampering the development of strategies to counteract AI. This case control study aimed to investigate iron metabolism during the development of AI in critically ill patients.MethodsIron metabolism in 30 patients who developed AI during ICU stay was compared with 30 septic patients with a high Hb and 30 non-septic patients with a high Hb. Patients were matched on age and sex. Longitudinally collected plasma samples were analyzed for levels of parameters of iron metabolism. A linear mixed model was used to assess the predictive values of the parameters.ResultsIn patients with AI, levels of iron, transferrin and transferrin saturation showed an early decrease compared to controls with a high Hb, already prior to the development of anemia. Ferritin, hepcidin and IL-6 levels were increased in AI compared to controls. During AI development, erythroferrone decreased. Differences in iron metabolism between groups were not influenced by APACHE IV score.ConclusionsThe results show that in critically ill patients with AI, iron metabolism is already altered prior to the development of anemia. Levels of iron regulators in AI differ from septic controls with a high Hb, irrespective of disease severity. AI is characterized by high levels of hepcidin, ferritin and IL-6 and low levels of iron, transferrin and erythroferrone.Electronic supplementary materialThe online version of this article (10.1186/s13613-018-0407-5) contains supplementary material, which is available to authorized users.

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“…Развитие анемии у пациентов в критическом состоянии связано с кровопотерей, обусловленной травмой, гемодилюцией и частым отбором проб крови. После 7 суток пребывания в стационаре анемия также может быть связана со сниженным образованием эритроцитов вследствие воспалительного процесса [2,6,7]. Развитие коагулопатии также связано с кровопотерей, гипоперфузией тканей вследствие травмы, а также с воспалением и острой активацией нейрогуморальной системы [8,9].…”

Section: Introductionunclassified

“…The development of anemia in critically ill patients is linked to blood loss due to a trauma, hemodilution and frequent blood sampling. After 7-day stay in hospital, anemia might be also linked to reduced production of red blood cells due to an inflammatory process [2,6,7]. The development of coagulopathy is commonly associated with blood loss, trauma-related hypoperfusion of tissues, as well as inflammation and acute activation of the neurohumoral system [8,9].…”

Section: Introductionmentioning

confidence: 99%

Effect of Fresh Frozen Plasma Transfusion on Electrochemical Parameters of Blood Plasma in Patients with Severe Combined Trauma

Горончаровская¹,

Евсеев²,

Шабанов³

et al. 2020

Obŝaâ reanimatologiâ

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Purpose: to study the dynamics of blood plasma electrochemical parameters in patients with severe combined trauma before and after fresh frozen plasma (FFP) transfusions.Materials and methods. The open circuit potential (OCP) of platinum electrode and antioxidant activity of blood plasma were studied in 35 patients with severe combined trauma and 35 post-FFP samples with at least 6-month shelf life. The electrochemical parameters of patients’ blood plasma were analyzed before transfusion, and 1 hr. and 24 hrs. after transfusion.Results. OCP measured in FFP was found to be more positive vs. OCP measured in recipients' blood plasma in 34 out of 35 cases (97%). It has been shown that in patients with severe combined trauma, OCP increased from 5.047 [-7.553; 12.976] mV to 12.827 [-1.372; 24.764] mV and antioxidant activity decreased 24 hours after FFP transfusion from 16.979 [11.302; 20.946] µC to 13.551 [9.288; 18.405] µC. After FFP transfusion, there were no signiﬁcant changes in clinical blood parameters.Conclusion. By measuring electrochemical parameters of blood plasma in patients with severe combined trauma before and after FFP transfusions, it was discovered that in spite of absence of changes in blood parameters by routine methods, there are changes in the condition of the antioxidant system of the body, which manifest in the bias of patients’ blood plasma OCP towards higher positive values and decreased antioxidant activity. Redox imbalance in the body might cause the oxidative stress development.

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Anemia in the ICU

Cited by 47 publications

References 32 publications

Stress Erythropoiesis is a Key Inflammatory Response

Stress Erythropoiesis is a Key Inflammatory Response

Iron metabolism in critically ill patients developing anemia of inflammation: a case control study

Effect of Fresh Frozen Plasma Transfusion on Electrochemical Parameters of Blood Plasma in Patients with Severe Combined Trauma

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