Anemia in surgical intensive care patients.
BACKGROUND
The cause of the anemia of patients in surgical intensive care units (SICU) is not completely clear but is likely to be multifactorial. This study investigated a possible role for immune activation in the anemia of SICU patients.


METHODS
Neopterin plasma levels, as a measure of T-cell-macrophage-axis activation, RBC-counts, Hb, Hct, MCV, MCH, MCHC, RDW, HDW, red cell morphology and iron status were determined in a group of 47 SICU patients.


RESULTS
The study confirms the presence of a moderate anemia (Hb = 10.38 +/- 13 g/dL) in SICU patients. Abnormal red blood cell morphology was observed in 82% of all patients over at least part of their ICU-stay. Markedly enhanced T-cell-macrophage-axis activity was evidenced by a significant increase in the plasma neopterin levels of the patient group (44 +/- 79.6 nmol/L) compared to that of the control group (3.38 +/- 4.9 nmol/L). Iron metabolism was found to be disturbed.


CONCLUSIONS
The red cell distribution width, the morphological results, the enhanced macrophage activation state, as well as the results of the iron status, point towards a contribution of an immune-associated functional iron deficiency to the anemia of SICU patients.
Viljoen
M
M
Department of Physiology, Faculty of Medicine, University of Pretoria, South Africa.
Coetzee
I H
IH
Roux
L J
LJ
Pretorius
J P
JP
D000740:Anemia / Q000453:epidemiology* / Q000276:immunology; D018798:Anemia, Iron-Deficiency / Q000453:epidemiology / Q000276:immunology; D015897:Comorbidity; D003422:Critical Care; D004909:Erythrocyte Indices; D004913:Erythrocytes, Abnormal / Q000473:pathology; D006801:Humans; D007239:Infections / Q000453:epidemiology; D007249:Inflammation / Q000453:epidemiology; D007501:Iron / Q000097:blood; D008262:Macrophage Activation; D019798:Neopterin / Q000097:blood*; D010865:Pilot Projects; D011183:Postoperative Complications / Q000453:epidemiology* / Q000276:immunology; D013019:South Africa / Q000453:epidemiology; D013601:T-Lymphocytes / Q000276:immunology
D019798:Neopterin; D007501:Iron