Red blood cell physiology in critical illness

被引:126
作者
Scharte, M [1 ]
Fink, MP
机构
[1] Univ Klinikum Munster, Klin & Poliklin Anasthesiol & Operat Intens Med, Munster, Germany
[2] Univ Pittsburgh, Sch Med, Dept Crit Care Med, Pittsburgh, PA USA
[3] Univ Pittsburgh, Sch Med, Dept Surg, Pittsburgh, PA USA
关键词
anemia; critical illness; cytokines; erythropoiesis; inflammation; red blood cells;
D O I
10.1097/01.CCM.0000098036.90796.ED
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objective. Reduction in red blood cell mass, as well as structural and functional alterations of erythrocytes, occurs in critical illness. This review discusses these changes in red blood cell physiology, emphasizing the pathogenesis of anemia in intensive care unit patients. Data Source. Studies published in biomedical journals. Data Synthesis and Conclusion. Anemia in intensive care unit patients resembles the anemia of chronic disease, being characterized by diminished erythropoietin production relative to decreased hematocrit, altered iron metabolism, and impaired proliferation and differentiation of erythroid progenitors in the bone marrow. Inflammatory mediators play a major role in the development of insufficient erythropoiesis and altered iron metabolism. Furthermore, a proinflammatory milieu promotes structural and functional alterations of erythrocytes, impairing their deformability and possibly impairing microvascular perfusion. Collectively, these changes in red blood cell physiology can impair oxygen transport to tissues and, thereby, might contribute to the development of multiple organ failure in critical illness.
引用
收藏
页码:S651 / S657
页数:7
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