Département d’anesthésie et de réanimation chirurgicale, Centre hospitalier universitaire Kremlin-Bicêtre, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre Cedex
- Key words: anemia, intensive care, erythropoietin, transfusion
- Page(s) : 44-9
- Published in: 2006
Anaemia is a common finding in critically ill patients. Obvious causes include surgical bleeding and gastrointestinal haemorrhage but many patients have no overt bleeding episodes. Phlebotomy can be a significant source of blood loss. In addition, critically ill patients have structural and functional alterations of red blood cells and impaired erythropoiesis as a consequence of blunted erythropoietin production. Pro-inflammatory factors are key factors in these alterations. The impact of the blood transfusion in ICU is only partially evaluated. There is no universal transfusion trigger. Most stable critically ill patients can probably be managed with a Hb concentration between 70 and 90 g/L. Uncertainties exist concerning the most appropriate Hb concentration for patients with significant cardiovascular diseases or with unstable hemodynamic state.