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Pathophysiology and management of anaemia in the critically ill 

Pathophysiology and management of anaemia in the critically ill
Chapter:
Pathophysiology and management of anaemia in the critically ill
Author(s):

Timothy Walsh

DOI:
10.1093/med/9780199600830.003.0273
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date: 28 October 2021

Anaemia is prevalent among the critically ill, with a multifactorial aetiology including haemodilution, iatrogenic blood loss, a reduced red cell lifespan, and especially decreased erythropoiesis. Acute inflammation probably has a major contribution to critical illness-induced anaemia, resulting in reduced iron absorption, sequestration of iron resulting in functional iron deficiency, relative erythropoietin deficiency, and impaired marrow red cell maturation. Anaemia during critical illness resembles the anaemia of chronic inflammatory disease, and probably results from similar pathophysiological processes. Current evidence does not support pharmacological manipulation of this process with iron or erythropoietin. Management should focus on minimization of blood loss and evidence-based use of red cells to maintain haemoglobin level.

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