Anaemia of Acute Illness

• 95% of ICU patients anaemia by day 3
• 50 [85]% of patients [>1wk on ICU] receive transfusions on ICU in US, avg 9.5 units, 40% during 1st week
• acute blood loss accounts only for 35% of transfusions

Causes

• diagnostic phlebotomy (accounts for 20% of total blood loss, ~60-80mL/day)
• occult/overt bleeding (wounds, drains, GIT)
• underproduction (blunted epo response, epo gene inhibition by cytokines, inflammation, altered iron metabolism & eryhtropoiesis)
• haematologically similar to anaemia of chronic disease (low iron, low TIBC, nml/hi Ferritin)