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Updated: May 2, 2026
Author Spotlight: Developing a Point-of-Care Hemoglobin Estimation Method for Anemia Management
Published on: January 19, 2024
[Anemia in the critically ill child and adult: a narrative review]
Insights
Anemia is common in intensive care units, impacting patient outcomes. Limiting blood draws and using evidence-based transfusion strategies are key to managing anemia in critically ill patients.
Area of Science:
- Critical Care Medicine
- Hematology
Context:
- Anemia is prevalent in pediatric and adult intensive care units (ICUs).
- Anemia impairs oxygen transport and is linked to poor prognosis in critically ill patients.
- Current anemia management in ICUs faces challenges, including diagnosis and treatment efficacy.
Purpose:
- To review current strategies for managing anemia in the intensive care unit.
- To highlight the importance of limiting blood draws and employing evidence-based transfusion practices.
- To identify remaining questions in optimizing anemia care for critically ill patients.
Summary:
- Limiting phlebotomy is a primary prophylactic measure against anemia.
- Red blood cell transfusions offer rapid hemoglobin increase but carry risks, necessitating evidence-based strategies.
- Iron supplementation may help in iron deficiency but diagnosis is challenging in critically ill patients.
- Erythropoietin's role is diminished in the current restrictive transfusion era.
Impact:
- Improved anemia management protocols in ICUs.
- Reduced patient harm associated with anemia and its treatments.
- Enhanced understanding of evidence-based practices for critically ill patients with anemia.
Abstract:
Anemia is frequent in the pediatric and adult intensive care unit. Anemia decreases oxygen transport which can be harmful in the critically ill patient; it is independently associated with a poor prognosis. The major prophylactic measure against anemia is the limitation of blood draws: several approaches can be used to limit phlebotomy overdraw without harming the patient. Red blood cell transfusion is the quickest way to increase the hemoglobin level, but it is not without risk. It is therefore important to promote the use of evidence-based transfusion strategies. Iron could be useful in case of iron deficiency, but this condition is difficult to diagnose in the critically ill patient. Erythropoietin is no longer relevant in the intensive care unit in the era of restrictive transfusion practice, at least for its hematological effects. Several questions remain to be addressed in order to improve anemia management in the intensive care unit.
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