Influence of transfusions, hemodialysis and extracorporeal life support on hyperferritinemia in critically ill patients

Autor: Frank M. Brunkhorst, Thomas Schenk, Patrick Heeren, Peter Nyvlt, Friederike S Schuster, Cornelia Knaak, Gunnar Lachmann, Claudia Spies, Gritta Janka, Paul La Rosée
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Male
Blood transfusion
medicine.medical_treatment
030204 cardiovascular system & hematology
Biochemistry
0302 clinical medicine
Mathematical and Statistical Techniques
Animal Cells
Red Blood Cells
Medicine and Health Sciences
Hospital Mortality
Multidisciplinary
biology
Statistics
Hematology
Middle Aged
C-Reactive Proteins
Clinical Laboratory Sciences
Hospitals
Intensive Care Units
Nephrology
Cohort
Physical Sciences
Regression Analysis
Medicine
SOFA score
Female
Hemodialysis
Cellular Types
Research Article
Adult
medicine.medical_specialty
Critical Illness
Science
Linear Regression Analysis
Research and Analysis Methods
03 medical and health sciences
Extracorporeal Membrane Oxygenation
Signs and Symptoms
Renal Dialysis
Diagnostic Medicine
Internal medicine
Sepsis
Medical Dialysis
medicine
Humans
Blood Transfusion
Statistical Methods
Aged
Hemophagocytic lymphohistiocytosis
Ferritin
Blood Cells
business.industry
Transfusion Medicine
Biology and Life Sciences
Proteins
Protein Complexes
Retrospective cohort study
Cell Biology
medicine.disease
Confidence interval
Health Care
Health Care Facilities
Ferritins
Multivariate Analysis
biology.protein
Linear Models
Hyperferritinemia
Clinical Medicine
business
Mathematics
030215 immunology
Zdroj: PLoS ONE, Vol 16, Iss 7, p e0254345 (2021)
PLoS ONE
ISSN: 1932-6203
Popis: Background Ferritin is the major iron storage protein and an acute phase reactant. Hyperferritinemia is frequently seen in the critically ill where it has been hypothesized that not only underlying conditions but also factors such as transfusions, hemodialysis and extracorporeal life support (ECLS) lead to hyperferritinemia. This study aims to investigate the influence of transfusions, hemodialysis, and ECLS on hyperferritinemia in a multidisciplinary ICU cohort. Methods This is a post-hoc analysis of a retrospective observational study including patients aged ≥ 18 years who were admitted to at least one adult ICU between January 2006 and August 2018 with hyperferritinemia ≥ 500 μg/L and of ≥ 14 days between two ICU ferritin measurements. Patients with hemophagocytic lymphohistiocytosis (HLH) were excluded. To identify the influence of transfusions, hemodialysis, and ECLS on ferritin change, multivariable linear regression analysis with ferritin change between two measurements as dependent variable was performed. Results A total of 268 patients was analyzed. Median duration between measurements was 36 days (22–57). Over all patients, ferritin significantly increased between the first and last measurement (p = 0.006). Multivariable linear regression analysis showed no effect of transfusions, hemodialysis, or ECLS on ferritin change. Changes in aspartate aminotransferase (ASAT) and sequential organ failure assessment (SOFA) score were identified as influencing factors on ferritin change [unstandardized regression coefficient (B) = 2.6; (95% confidence interval (CI) 1.9, 3.3); p < 0.001 and B = 376.5; (95% CI 113.8, 639.1); p = 0.005, respectively]. Using the same model for subgroups of SOFA score, we found SOFA platelet count to be associated with ferritin change [B = 1729.3; (95% CI 466.8, 2991.9); p = 0.007]. No association of ferritin change and in-hospital mortality was seen in multivariable analysis. Conclusions The present study demonstrates that transfusions, hemodialysis, and ECLS had no influence on ferritin increases in critically ill patients. Hyperferritinemia appears to be less the result of iatrogenic influences in the ICU thereby underscoring its unskewed diagnostic value. Trial registration The study was registered with www.ClinicalTrials.gov (NCT02854943) on August 1, 2016.
Databáze: OpenAIRE
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