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Iron Deficiency in ICU Patients Tied to Higher Transfusion Rate

Low reticulocyte hemoglobin content is common in ICU patients; may signal transfusion need

FRIDAY, May 7 (HealthDay News) -- In patients admitted to an intensive care unit (ICU), functional iron deficiency -- defined as low reticulocyte hemoglobin content (CHr) -- is common, and is strongly associated with higher transfusion requirements, according to a study in the May issue of Anesthesiology.

Rafael Fernandez, M.D., of the Hospital Sant Joan de Déu—Fundació Althaia in Manresa, Spain, and colleagues conducted a prospective cohort study of 62 ICU patients, including 23 (37 percent) who presented with low CHr on admission.

Compared to patients with normal CHr, the researchers found that those with low CHr were sicker; were more likely to have sepsis; had a higher rate of complications such as acute renal failure (39 versus 13 percent) and ICU-acquired infection (30 versus 10 percent); had a longer median stay (eight versus five days); and had a higher rate of transfusion (39.1 versus 12.8 percent). After adjusting for severity of illness, age, trauma, and hemoglobin level, they found that low CHr was still associated with an increased likelihood of transfusion (hazard ratio, 3.6), however, they did not find statistically significant mortality differences between normal-CHr and low-CHr patients.

"Therefore, critically ill patients with low CHr appear to be suitable subjects for future studies to determine whether early treatment with intravenous iron after ICU admission can reduce transfusion requirements," the authors write.

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