Abstract
Critically ill patients represent a heterogeneous group of patients with a broad array of (co)morbidities. Although highly diverse, one characteristic that applies to practically all critically ill patients is a greatly disturbed iron homeostasis. Iron redistribution is one of the key factors contributing to the development of anemia, which is common on the intensive care unit (ICU). Nearly all patients develop anemia during their ICU stay [1, 2]. Although blood transfusions are independently associated with worse outcome, 40 to 50 % of patients receive one or more transfusions during their ICU stay [1]. This underscores the need to understand ICU-related anemia and find alternative therapies. The field of iron biology has experienced an enormous surge of interest since the discovery of hepcidin in 2001, the key regulator of iron homeostasis [3]. Since then, many investigations have focused on iron homeostasis and its interactions with inflammation, which are numerous. Although most of the pathophysiological mechanisms have been clarified in animal models and chronically inflamed patients, studies in the critically ill are limited. However, although anemia on the intensive care is frequently encountered, awareness of the changes in iron balance that accompany or underlie this anemia is low. This review provides an overview of iron biology during inflammation, and clarifies its relation with microbial virulence, immunity, and oxidative stress reactions. In addition, consequences for the critically ill patient are discussed.
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van Eijk, L.T., Swinkels, D.W., Pickkers, P. (2014). Review on Iron, Immunity and Intensive Care. In: Vincent, JL. (eds) Annual Update in Intensive Care and Emergency Medicine 2014. Annual Update in Intensive Care and Emergency Medicine, vol 2014. Springer, Cham. https://doi.org/10.1007/978-3-319-03746-2_2
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DOI: https://doi.org/10.1007/978-3-319-03746-2_2
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