Anemia, Iron Deficiency, Anemia of Chronic Disease
Conditions
Brief summary
Critical patients which requiring admission to intensive care (IT) are a special group of patients. In these patients the prevalence of anemia reported in studies is 75%. This prevalence is similar to that in the retrospective observational study conducted in our intensive care unit(ICU). Of the 783 patients included in the study, 551 (73.37%) had anemia on admission. Frequently anemia is present on discharge from ICU or hospital and may persist for an average of 11 weeks. Some studies have reported the presence of anemia as far as 6 months after discharge. It is widely accepted that anemia has a negative impact on rehabilitation and quality of life, but the treatment can not be exclusively based on blood products due to the risks associated with transfusion. Alternative treatments such as injectable iron or erythropoietin should be considered. The Transfusion Management Initiative Group recently issued recommendations on perioperative anemia. Similar recommendations for ICU have not yet been developed in Romania. The current study has two main purposes. The first to adopt the perioperative anemia diagnostic algorithm and adapt it to anemic patients on ICU; the second to identify patients with mixed anemia (inflammatory and iron deficient anemia) who can benefit from treatment with iron.
Interventions
None listed
Sponsors
Iuliu Hatieganu University of Medicine and Pharmacy
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients admitted to ICU ICU stay \>48hours
Exclusion criteria
* Refusal to participate in the study * Allergy to iron products * Anemia requiring massive transfusion in the last 7 days * Treatment of iron products in the last 7 days * Chronic renal failure with GFR \<30mL / min or on dialysis * Metabolism of iron * Pregnant or lactation patients * Rheumatic diseases * Inflammatory bowel diseases * Hematological pathologies * Impossibility of performing laboratory tests within 72 hours of admission
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Number of transfusions during ICU stay | Up to 3 months of hospital stay |
| Change in hemoglobin levels during ICU stay | 21 days: day 0=point 1; day 7=point 2; day 14=point 3; day 21 =point 4; |
Secondary
| Measure | Time frame |
|---|---|
| Number of hours of mechanical ventilation during hospital stay | Up to 3 months |
| Days spent in hospital | Up to 3 months |
| Days spent on ICU | Up to 3 months of hospital stay |
| Change in hemoglobin level during hospital stay | Up to 3 months: week 3=point 1; week 6=point 2; week 9=point 3; week 12=point4 |
Other
| Measure | Time frame | Description |
|---|---|---|
| Change in hepcidin levels | Days 0, 3, 7, 14, 21 | Hepcidin is a peptide produced by the liver. It acts by binding to ferroportin, the sole exporter of iron. The hepcidin-ferroportin complex is sequestrated in the cytosol of cells followed by its degradation. Ferroportin degradation prevents iron from being exported from the cell. |
Countries
Romania
Contacts
Primary ContactRobert Szabo, Resident MD
Outcome results
None listed