ABSTRACT
Acute events in medicine often lead to anemia. Many patients become anemic not only after surgery but also during sepsis and during their stay in an intensive care unit (ICU). After 3 days on ICU, about 95% of patients have hemoglobin concentrations below normal (1). At first sight, this seems the result of blood loss including frequent blood drawing, invasive procedures, and gastrointestinal blood loss. But apart from hypoferremia, the acute event-related anemia, as observed in ICU patients, bears no resemblance to iron deficiency (2). With high ferritin and low-to-normal transferrin and serum transferrin receptor levels, it shares characteristics with the anemia of chronic disease as found in patients with infectious
diseases, inflammatory disorders, and malignancies. This suggests other mechanisms to be operative as well such as a blunted erythropoietin (EPO) response and suppression of erythropoiesis by inflammatory cytokines.
