Receiving a blood transfusion in the intensive care unit (ICU) is not
uncommon, but reliable predictors for patients that will require
transfusion are not readily available. A new study published in the May
issue of Anesthesiology seeks to reduce the occurrence of ICU
transfusions, revealing a new marker for patients at higher risk for
developing severe anemia and subsequently requiring transfusion in the
In this study,
Rafael Fernandez, M.D., Ph.D. and colleagues set out to determine if
patients with functional iron deficiency (called CHr) was associated
with transfusion requirements in ICU patients.
“Previous studies have indicated that anemia
is a common occurrence in ICU patients and is even associated with
greater patient mortality while admitted to the hospital,” said Dr.
Fernandez. “Our study was designed as an observational investigation
looking for clues about anemia in critically ill patients and
associations between iron deficiency, a common cause of anemia, at ICU
admission and the requirement for transfusion.”
About the Study
Researchers examined patients admitted to a
16-bed ICU over a two month period. During that time period 75 patients
were admitted. A total of 62 patients had an ICU stay of greater than
48 hours and were included in the study.
Of these patients,
23 were admitted with iron deficiency. Patients presenting with iron
deficiency were found to be sicker and more likely to have sepsis.
These patients were also found to be prone to complications in
particular renal failure (37 percent) and ICU-acquired infection (30
transfusion rate for patients was 22.6 percent, a rate that was higher
in patients with low CHr levels signaling iron deficiency than in
patients with normal-CHr (39.1 percent to 12.8 percent).
Dr. Fernandez commented on the significance
of the study results: “The fact that iron deficiency was associated
with a higher need for a transfusion and higher likelihood of mortality
in this group should reinforce the impact iron levels can have on
surgical outcomes. Whenever possible, iron levels should be
well-managed prior to admission.”
Further research on
the significance of iron deficiency and need for blood transfusion is
required. Dr. Fernandez and colleagues recommend that critically ill
patients with low CHr levels are included in future studies to
determine if early treatment with intravenous iron after ICU admission
could reduce the need for transfusions.
The American Society of Anesthesiologists
Anesthesiologists: Physicians providing
the lifeline of modern medicine. Founded in 1905, the American Society
of Anesthesiologists is an educational, research and scientific
association with 44,000 members organized to raise and maintain the
standards of the medical practice of anesthesiology and improve the
care of the patient.