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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Emergency Clinical County Hospital Group | |||
| Municipal Clinical Hospital Group |
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| Measure | Description | Time Frame |
|---|---|---|
| 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; | |
| Number of transfusions during ICU stay | Up to 3 months of hospital stay |
| Measure | Description | Time Frame |
|---|---|---|
| Days spent on ICU | Up to 3 months of hospital stay | |
| Days spent in hospital | Up to 3 months | |
| Change in hemoglobin level during hospital stay |
| Measure | Description | Time Frame |
|---|---|---|
| Change in hepcidin levels | 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. | Days 0, 3, 7, 14, 21 |
Inclusion Criteria:
Patients admitted to ICU
ICU stay >48hours
Exclusion Criteria:
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All patients admitted to ICU during the study period which do not meet any exclusion criteria
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Robert Szabo, Resident MD | Contact | 0040755628255 | robsz11@yahoo.com |
| Name | Affiliation | Role |
|---|---|---|
| Constantin Bodolea, Md PhD | 2nd Anesthesia Department of University of Medicine and Pharmacy Cluj Napoca | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Emergency Clinical County Hospital Cluj Napoca | Cluj-Napoca | Cluj | Romania |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29090267 | Background | Filipescu D, Banateanu R, Beuran M, Burcos T, Corneci D, Cristian D, Diculescu M, Dobrota A, Droc G, Isacoff D, Gosa D, Grintescu I, Lupu A, Mirea L, Posea C, Stanca O, Stefan M, Tomescu D, Tudor C, Ungureanu D, Mircescu G. Perioperative Patient Blood Management Programme. Multidisciplinary recommendations from the Patient Blood Management Initiative Group. Rom J Anaesth Intensive Care. 2017 Oct;24(2):139-157. doi: 10.21454/rjaic.7518.242.fil. |
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| ID | Term |
|---|---|
| D018798 | Anemia, Iron-Deficiency |
| ID | Term |
|---|---|
| D000747 | Anemia, Hypochromic |
| D000740 | Anemia |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
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| Up to 3 months: week 3=point 1; week 6=point 2; week 9=point 3; week 12=point4 |
| Number of hours of mechanical ventilation during hospital stay | Up to 3 months |
| Municipal Clinical Hospital Cluj | Cluj-Napoca | Cluj | Romania |
|
| D000090463 |
| Iron Deficiencies |
| D019189 | Iron Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |