title: Erythropoiesis in multiply injured patients.
abstract: Posttraumatic anemia in multiply injured patients is caused by hemorrhage, reduced red blood cell survival, and impaired erythropoiesis. Trauma-induced hyperinflammation causes impaired bone-marrow function by means of blunted erythropoietin (EPO) response, reduced iron availability, suppression and egress of erythroid progenitor cells. To treat posttraumatic anemia in severely injured patients, symptomatic therapy by blood transfusion is not sufficient. Furthermore, EPO, iron, and the use of red cell substitutes should be considered. The posttraumatic systemic inflammatory response syndrome (SIRS) induces posttraumatic anemia. Thus, a worsening of SIRS by a "second-hit" through blood transfusion ought to be avoided.
authors.affiliation: Department of Trauma and Reconstructive Surgery, Charité - Campus Benjamin Franklin, Berlin, Germany. yohan.robinson@charite.de
authors.forename: Yohan
authors.initials: Y
authors.lastname: Robinson
authors.forename: Arwed
authors.initials: A
authors.lastname: Hostmann
authors.forename: Alexander
authors.initials: A
authors.lastname: Matenov
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Ertel
authors.forename: Andreas
authors.initials: A
authors.lastname: Oberholzer
mesh_terms: D000740:Anemia / Q000209:etiology*; D017707:Erythrocyte Transfusion; D004912:Erythrocytes / Q000473:pathology; D004920:Erythropoiesis / Q000502:physiology*; D005440:Fluid Therapy; D006470:Hemorrhage / Q000150:complications; D006801:Humans; D007501:Iron / Q000502:physiology*; D000090463:Iron Deficiencies; D009104:Multiple Trauma / Q000503:physiopathology*; D012151:Resuscitation / Q000379:methods; D018746:Systemic Inflammatory Response Syndrome / Q000503:physiopathology
chemical_list: D007501:Iron