The effect of red blood cell transfusion on iron metabolism in critically ill patients
| Autor: | Margit Boshuizen, Maike E. van Hezel, Nicole P. Juffermans, Lisa van Manen, Robin van Bruggen, Marleen Straat, Yvemarie B O Somsen, Angelique M.E. Spoelstra de Man, Neil Blumberg |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Anemia Immunology 030204 cardiovascular system & hematology Gastroenterology 03 medical and health sciences 0302 clinical medicine Hepcidin Internal medicine medicine Immunology and Allergy medicine.diagnostic_test biology business.industry Transferrin saturation Haptoglobin Hematology medicine.disease Hemolysis Red blood cell medicine.anatomical_structure Serum iron biology.protein Erythropoiesis business 030215 immunology |
| Zdroj: | Transfusion. 59:1196-1201 |
| ISSN: | 0041-1132 |
| Popis: | BACKGROUND: Anemia of inflammation (AI) has a high prevalence in critically ill patients. In AI, iron metabolism is altered, as high levels of inflammation-induced hepcidin reduce the amount of iron available for erythropoiesis. AI is treated with red blood cell (RBC) transfusions. The effect of RBC transfusion on iron metabolism during inflammatory processes in adults is unknown. We investigated the effect of RBC transfusion on iron metabolism in critically ill patients. METHODS: In a prospective cohort study in 61 critically ill patients who received 1 RBC unit, levels of iron variables were determined before, directly after, and 24 hours after transfusion in septic and nonseptic patients. RESULTS: Serum iron levels were low and increased after transfusion (p = 0.02). However, RBC transfusion had no effect on transferrin saturation (p = 0.14) and ferritin levels (p = 0.74). Hepcidin levels increased after RBC transfusion (p = 0.01), while interleukin-6 levels decreased (p = 0.03). In septic patients, RBC transfusion induced a decrease in haptoglobin levels compared to baseline, which did not occur in nonseptic patients (p = 0.01). The effect of RBC transfusion on other iron variables did not differ between septic and nonseptic patients. CONCLUSION: Transfusion of a RBC unit transiently increases serum iron levels in intensive care unit patients. The increase in hepcidin levels after transfusion can further decrease iron release from intracellular storage making it available for erythropoiesis. RBC transfusion is associated with a decrease in haptoglobin levels in septic compared to nonseptic patients, but did not affect other markers of hemolysis. |
| Databáze: | OpenAIRE |
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