Managing anemia in the critically ill patient.
Anemia of critical illness is a multifactorial condition caused by phlebotomy, ongoing blood loss, and inadequate production of red blood cells. It occurs early in the course of critical illness. Although red blood cell transfusion is the treatment of choice for immediate management of anemia in the intensive care unit, controversy surrounds the most appropriate hemoglobin concentration or hematocrit "trigger." Therapeutic options, including blood-conservation tools, minimization of phlebotomy, erythropoietic agents, and investigational oxygen-carrying agents, may be alternatives to red blood cell transfusions in critically ill patients with anemia. Patient selection for erythropoietic agents will depend on further work dealing with outcomes and the total cost of care in managing the anemia of critical illness.
Rudis
Maria I
MI
Department of Pharmacy, School of Pharmacy, University of Southern California, Los Angeles, California 90033, USA. rudis@hsc.usc.edu
Jacobi
Judith
J
Hassan
Erkan
E
Dasta
Joseph F
JF
D000740:Anemia / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D000818:Animals; D001424:Bacterial Infections / Q000635:transmission; D003422:Critical Care / Q000379:methods; D016638:Critical Illness / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D012307:Risk Factors; D065227:Transfusion Reaction; D014777:Virus Diseases / Q000635:transmission