Physiologic effects of normovolemic anemia: implications for clinical monitoring

Normovolemic anemia is commonly found in acute and critically ill adults. Compensatory physiologic effects of anemia are governed by the extent and rate of development of the anemia as well as by chronic or acute diseases that limit physiologic reserves. Increased metabolic demands that frequently accompany critical illness confound how patients will tolerate anemia. Clinicians should be aware of the physiologic responses to anemia, to monitor for intolerance and prevent negative outcomes. In this article, the author reviews specific physiologic responses occurring in adults with normovolemic anemia and describes appropriate clinical monitoring parameters.