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Review Article| Volume 20, ISSUE 2, P313-324, April 2004

Blood conservation for critically ill patients

      Anemia may be the most common illness of critically ill patients [
      • Vincent J.L
      • Baron J.-F
      • Reinhart K
      • et al.
      Anemia and blood transfusion in critically ill patients.
      ,
      • Levy M
      ,
      • Hébert P.C
      • Wells G
      • Marshall J
      • et al.
      Transfusion requirements in critical care: a pilot study.
      ,
      • Hébert P.C
      • Wells G
      • Blajchman M
      • et al.
      A Multicenter, randomized, controlled clinical trial of transfusion requirements in critical care.
      ]. The majority of critically ill patients are anemic at admission to the intensive care unit (ICU), and hemoglobin concentrations typically decline by > 0.5 g/dL/day during the first 3 days of ICU stay. Hemoglobin continues to decline for patients with sepsis and higher severity of illness [
      • Vincent J.L
      • Baron J.-F
      • Reinhart K
      • et al.
      Anemia and blood transfusion in critically ill patients.
      ,
      • Ba V.N
      • Bota D.P
      • Melot C
      • et al.
      Time course of hemoglobin concentration in nonbleeding intensive care unit patients.
      ]. This patient population may be at particular risk of adverse consequences of anemia given the cardiovascular, respiratory, and metabolic compromise frequently encountered during critical illness. The etiology of anemia of critical illness is multifactorial, resulting from phlebotomy, gastrointestinal bleeding, coagulation disorders, blood loss from vascular procedures, renal failure, nutritional deficiencies, bone marrow suppression, and impaired erythropoietin response [
      • Corwin H.L
      • Parsonnet K.C
      • Gettinger A
      RBC transfusion in the ICU: is there a reason?.
      ].
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