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

Martin Darveau¹^,2 , André Y Denault³, Normand Blais⁴ and Éric Notebaert⁵

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

²Cité de la Santé de Laval, Québec, Canada

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

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

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

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


Published:	13 May 2004

See related commentary, http://ccforum.com/content/8/5/306

Abstract

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.