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Bench-to-bedside review: Iron metabolism in critically ill patients

Martin Darveau12*, André Y Denault3, Normand Blais4 and Éric Notebaert5

Author Affiliations

1 Research student, Faculty of Pharmacy, University of Montreal, Quebec, Canada

2 Cité de la Santé de Laval, Québec, Canada

3 Clinical Assistant Professor of Anesthesia, University of Montreal, Montreal Heart Institute and Centre Hospitalier de l'Université de Montréal, Québec, Canada

4 Hematologist, Hematology Department, Cité de la Santé de Laval, Québec, Canada

5 Clinical Assistant Professor of Medicine, Critical Care Department, Cité de la Santé de Laval, Québec, Canada

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Critical Care 2004, 8:356-362  doi:10.1186/cc2862

See related commentary,

Published: 13 May 2004


Critically ill patients frequently develop anemia due to several factors. Iron-withholding mechanisms caused by inflammation contribute to this anemia. The iron metabolism imbalances described or reported in all intensive care studies are similar to the values observed in anemia of inflammation. The administration of iron could be useful in the optimization of recombinant human erythropoietin activity, but this could be at the expense of bacterial proliferation. Since there is a lack of evidence to support either oral or intravenous iron administration in intensive care patients, further studies are necessary to determine the efficacy and safety of iron supplementation in conjunction with recombinant human erythropoietin in critically ill patients. We review the mechanisms leading to iron sequestration in the presence of inflammation. The present article also reviews the literature describing the iron status in critically ill patients and explores the role of iron supplementation in this setting.

critical illness; erythropoiesis; iron metabolism