ANEMIA IN CRITICALLY ILL PATIENTS; PREVALENCE AND PROGNOSTIC IMPLICATIONS

Abstract

nemia of critical illness is defined as anemia in the critically ill patient that cannot be explained by other causes and that is characterized by an inadequate response of endogenous erythropoietin in relation to the degree of hemoglobin deficiency present. It is a significant issue in critical care especially it is present in 97% of patients in the ICU at Day 8 and around 77% of patients are still anemic at hospital discharge (1,2). The etiology of anemia in critical illness is multifactorial and complex. Repeated phlebotomies, gastrointestinal blood loss, and other surgical procedures contribute significantly to the development of anemia. Other factors involved in pathogenesis include coagulopathies, pathogen-associated hemolysis, hypoadrenalism, and nutritional deficiencies. More than one third of patients in intensive care units (ICUs) require red blood cell (RBC) transfusion to maintain a target hemoglobin concentration of 7 g/dL. Since anemia and RBC transfusion are associated with worse clinical outcomes in critically ill patients, it is important to prevent anemia and the need for RBC transfusion in critically ill patients, which may improve the quality and clinical outcomes of critical care. In the last two decades transfusion practices have become more restrictive likely in response to prospective research.