Anemia of Inflammation and Deficiency Anemia

Study Overview
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Brief Summary
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Critical patients which requiring admission to intensive care (IT) are a special group of patients. In these patients the prevalence of anemia reported in studies is 75%. This prevalence is similar to that in the retrospective observational study conducted in our intensive care unit(ICU). Of the 783 patients included in the study, 551 (73.37%) had anemia on admission. Frequently anemia is present on discharge from ICU or hospital and may persist for an average of 11 weeks. Some studies have reported the presence of anemia as far as 6 months after discharge. It is widely accepted that anemia has a negative impact on rehabilitation and quality of life, but the treatment can not be exclusively based on blood products due to the risks associated with transfusion. Alternative treatments such as injectable iron or erythropoietin should be considered. The Transfusion Management Initiative Group recently issued recommendations on perioperative anemia. Similar recommendations for ICU have not yet been developed in Romania. The current study has two main purposes. The first to adopt the perioperative anemia diagnostic algorithm and adapt it to anemic patients on ICU; the second to identify patients with mixed anemia (inflammatory and iron deficient anemia) who can benefit from treatment with iron.

Official Title
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Anemia of Inflammation and Deficiency Anemia in Critically Ill Patients; Biological Markers

Conditions
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Anemia, Iron Deficiency, Anemia of Chronic Disease

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients admitted to ICU ICU stay >48hours Exclusion Criteria: Refusal to participate in the study Allergy to iron products Anemia requiring massive transfusion in the last 7 days Treatment of iron products in the last 7 days Chronic renal failure with GFR <30mL / min or on dialysis Metabolism of iron Pregnant or lactation patients Rheumatic diseases Inflammatory bowel diseases Hematological pathologies Impossibility of performing laboratory tests within 72 hours of admission

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Emergency Clinical County Hospital Group<br> | |
| Municipal Clinical Hospital Group<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in hemoglobin levels during ICU stay |  | 21 days: day 0=point 1; day 7=point 2; day 14=point 3; day 21 =point 4; | 
| Number of transfusions during ICU stay |  | Up to 3 months of hospital stay | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Days spent on ICU |  | Up to 3 months of hospital stay | 
| Days spent in hospital |  | Up to 3 months | 
| Change in hemoglobin level during hospital stay |  | Up to 3 months: week 3=point 1; week 6=point 2; week 9=point 3; week 12=point4 | 
| Number of hours of mechanical ventilation during hospital stay |  | Up to 3 months |