Prevalence of iron deficiency on ICU discharge and its relation with fatigue: a multicenter prospective study

详细信息    查看全文

• 作者：Sigismond Lasocki (1) (6)
  Nicolas Chudeau (1)
  Thibaut Papet (2)
  Deborah Tartiere (3)
  Antoine Roquilly (4)
  Laurence Carlier (1)
  Olivier Mimoz (2)
  Philippe Seguin (3)
  Yannick Malledant (3)
  Karim Asehnoune (4)
  Jean Fran莽ois Hamel (5)
  for the AtlanREA group
  
  1. R茅animation Chirurgicale Centre Hospitalier Universitaire ; Angers ; France
  6. LUNAM Universit茅 ; Universit茅 d鈥橝ngers ; CHU d鈥橝ngers ; Pole d鈥橝nesth茅sie-R茅animation Chirurgicale ; 4 rue Larrey ; 49933 ; Angers ; Cedex 9 ; France
  2. R茅animation Chirurgicale Centre Hospitalier Universitaire ; Poitiers ; France
  3. R茅animation Chirurgicale Centre Hospitalier Universitaire ; Rennes ; France
  4. R茅animation Chirurgicale Centre Hospitalier Universitaire ; Nantes ; France
  5. Centre de Recherche Clinique ; Centre Hospitalier Universitaire ; Angers ; France
  
• 刊名：Critical Care
• 出版年：2014
• 出版时间：October 2014
• 年：2014
• 卷：18
• 期：5
• 全文大小：946 KB
• 参考文献：1. Vincent, JL, Baron, JF, Reinhart, K, Gattinoni, L, Thijs, L, Webb, A, Meier-Hellmann, A, Nollet, G, Peres-Bota, D (2002) Anemia and blood transfusion in critically ill patients. JAMA 288: pp. 1499-1507 CrossRef
  2. Corwin, HL, Gettinger, A, Pearl, RG, Fink, MP, Levy, MM, Abraham, E, MacIntyre, NR, Shabot, MM, Duh, MS, Shapiro, MJ (2004) The CRIT Study: anemia and blood transfusion in the critically ill鈥揷urrent clinical practice in the United States. Crit Care Med 32: pp. 39-52 CrossRef
  3. From the Centers for Disease Control and Prevention. Iron deficiency-United States, 1999-2000. / JAMA 2002, 288:2114鈥?116.
  4. Piagnerelli, M, Vincent, JL (2004) Role of iron in anaemic critically ill patients: it's time to investigate!. Crit Care 8: pp. 306-307 CrossRef
  5. Pieracci, FM, Barie, PS (2006) Diagnosis and management of iron-related anemias in critical illness. Crit Care Med 34: pp. 1898-1905 CrossRef
  6. Lasocki, S, Longrois, D, Montravers, P, Beaumont, C (2011) Hepcidin and anemia of the critically ill patient. Anesthesiology 114: pp. 688-694 CrossRef
  7. Bellamy, MC, Gedney, JA (1998) Unrecognised iron deficiency in critical illness. Lancet 352: pp. 1903 CrossRef
  8. Fernandez, R, Tubau, I, Masip, J, Munoz, L, Roig, I, Artigas, A (2010) Low reticulocyte hemoglobin content is associated with a higher blood transfusion rate in critically ill patients: a cohort study. Anesthesiology 112: pp. 1211-1215 CrossRef
  9. Lasocki, S, Baron, G, Driss, F, Westerman, M, Puy, H, Boutron, I, Beaumont, C, Montravers, P (2010) Diagnostic accuracy of serum hepcidin for iron deficiency in critically ill patients with anemia. Intensive Care Med 36: pp. 1044-1048 CrossRef
  10. Munoz, M, Romero, A, Morales, M, Campos, A, Garcia-Erce, JA, Ramirez, G (2005) Iron metabolism, inflammation and anemia in critically ill patients. A cross-sectional study. Nutr Hosp 20: pp. 115-120
  11. Pieracci, FM, Henderson, P, Rodney, JR, Holena, DN, Genisca, A, Ip, I, Benkert, S, Hydo, LJ, Eachempati, SR, Shou, J, Barie, PS (2009) Randomized, double-blind, placebo-controlled trial of effects of enteral iron supplementation on anemia and risk of infection during surgical critical illness. Surg Infect (Larchmt) 10: pp. 9-19 CrossRef
  12. Rodriguez, RM, Corwin, HL, Gettinger, A, Corwin, MJ, Gubler, D, Pearl, RG (2001) Nutritional deficiencies and blunted erythropoietin response as causes of the anemia of critical illness. J Crit Care 16: pp. 36-41 CrossRef
  13. Iperen, CE, Gaillard, CA, Kraaijenhagen, RJ, Braam, BG, Marx, JJ, Wiel, A (2000) Response of erythropoiesis and iron metabolism to recombinant human erythropoietin in intensive care unit patients. Crit Care Med 28: pp. 2773-2778 CrossRef
  14. Ahsen, N, Muller, C, Serke, S, Frei, U, Eckardt, KU (1999) Important role of nondiagnostic blood loss and blunted erythropoietic response in the anemia of medical intensive care patients. Crit Care Med 27: pp. 2630-2639 CrossRef
  15. Lyon, AW, Chin, AC, Slotsve, GA, Lyon, ME (2013) Simulation of repetitive diagnostic blood loss and onset of iatrogenic anemia in critical care patients with a mathematical model. Comput Biol Med 43: pp. 84-90 CrossRef
  16. Piednoir, P, Allou, N, Driss, F, Longrois, D, Philip, I, Beaumont, C, Montravers, P, Lasocki, S (2011) Preoperative iron deficiency increases transfusion requirements and fatigue in cardiac surgery patients: a prospective observational study. Eur J Anaesthesiol 28: pp. 796-801 CrossRef
  17. Finch, CA, Miller, LR, Inamdar, AR, Person, R, Seiler, K, Mackler, B (1976) Iron deficiency in the rat. Physiological and biochemical studies of muscle dysfunction. J Clin Invest 58: pp. 447-453 CrossRef
  18. Willis, WT, Gohil, K, Brooks, GA, Dallman, PR (1990) Iron deficiency: improved exercise performance within 15聽hours of iron treatment in rats. J Nutr 120: pp. 909-916
  19. Krayenbuehl, PA, Battegay, E, Breymann, C, Furrer, J, Schulthess, G (2011) Intravenous iron for the treatment of fatigue in nonanemic, premenopausal women with low serum ferritin concentration. Blood 118: pp. 3222-3227 CrossRef
  20. AtlanRea. [www.atlanrea.org]
  21. Anker, SD, Comin Colet, J, Filippatos, G, Willenheimer, R, Dickstein, K, Drexler, H, Luscher, TF, Bart, B, Banasiak, W, Niegowska, J, Kirwan, BA, Mori, C, Eisenhart Rothe, B, Pocock, SJ, Poole-Wilson, PA, Ponikowski, P (2009) Ferric carboxymaltose in patients with heart failure and iron deficiency. N Engl J Med 361: pp. 2436-2448 CrossRef
  22. Jankowska, EA, Rozentryt, P, Witkowska, A, Nowak, J, Hartmann, O, Ponikowska, B, Borodulin-Nadzieja, L, Banasiak, W, Polonski, L, Filippatos, G, McMurray, JJ, Anker, SD, Ponikowski, P (2010) Iron deficiency: an ominous sign in patients with systolic chronic heart failure. Eur Heart J 31: pp. 1872-1880 CrossRef
  23. Okonko, DO, Mandal, AK, Missouris, CG, Poole-Wilson, PA (2011) Disordered iron homeostasis in chronic heart failure: prevalence, predictors, and relation to anemia, exercise capacity, and survival. J Am Coll Cardiol 58: pp. 1241-1251 CrossRef
  24. Mathiowetz, V, Kashman, N, Volland, G, Weber, K, Dowe, M, Rogers, S (1985) Grip and pinch strength: normative data for adults. Arch Phys Med Rehabil 66: pp. 69-74
  25. Smets, EM, Garssen, B, Bonke, B, Haes, JC (1995) The Multidimensional Fatigue Inventory (MFI) psychometric qualities of an instrument to assess fatigue. J Psychosom Res 39: pp. 315-325 CrossRef
  26. Gentile, S, Delaroziere, JC, Favre, F, Sambuc, R, San Marco, JL (2003) Validation of the French 'multidimensional fatigue inventory' (MFI 20). Eur J Cancer Care (Engl) 12: pp. 58-64 CrossRef
  27. Heming, N, Montravers, P, Lasocki, S (2011) Iron deficiency in critically ill patients: highlighting the role of hepcidin. Crit Care 15: pp. 210 CrossRef
  28. Thomas, DW, Hinchliffe, RF, Briggs, C, Macdougall, IC, Littlewood, T, Cavill, I (2013) Guideline for the laboratory diagnosis of functional iron deficiency. Br J Haematol 161: pp. 639-648 CrossRef
  29. Urrechaga, E, Borque, L, Escanero, JF (2009) Potential utility of the new Sysmex XE 5000 red blood cell extended parameters in the study of disorders of iron metabolism. Clin Chem Lab Med 47: pp. 1411-1416 CrossRef
  30. Urrechaga, E (2009) The new mature red cell parameter, low haemoglobin density of the Beckman-Coulter LH750: clinical utility in the diagnosis of iron deficiency. Int J Lab Hematol 32: pp. e144-e150 CrossRef
  31. Thomas, L, Franck, S, Messinger, M, Linssen, J, Thome, M, Thomas, C (2005) Reticulocyte hemoglobin measurement鈥揷omparison of two methods in the diagnosis of iron-restricted erythropoiesis. Clin Chem Lab Med 43: pp. 1193-1202 CrossRef
  32. Thomas, C, Kirschbaum, A, Boehm, D, Thomas, L (2006) The diagnostic plot: a concept for identifying different states of iron deficiency and monitoring the response to epoetin therapy. Med Oncol 23: pp. 23-36 CrossRef
  33. Weiss, G, Goodnough, LT (2005) Anemia of chronic disease. N Engl J Med 352: pp. 1011-1023 CrossRef
  34. Lasocki, S, Millot, S, Andrieu, V, Letteron, P, Pilard, N, Muzeau, F, Thibaudeau, O, Montravers, P, Beaumont, C (2008) Phlebotomies or erythropoietin injections allow mobilization of iron stores in a mouse model mimicking intensive care anemia. Crit Care Med 36: pp. 2388-2394 CrossRef
  35. Bateman, AP, McArdle, F, Walsh, TS (2009) Time course of anemia during six months follow up following intensive care discharge and factors associated with impaired recovery of erythropoiesis. Crit Care Med 37: pp. 1906-1912 CrossRef
  36. Haas, JD, Brownlie, T (2001) Iron deficiency and reduced work capacity: a critical review of the research to determine a causal relationship. J Nutr 131: pp. 676S-688S
  37. Patterson, AJ, Brown, WJ, Powers, JR, Roberts, DC (2000) Iron deficiency, general health and fatigue: results from the Australian Longitudinal Study on Women's Health. Qual Life Res 9: pp. 491-497 CrossRef
  38. Javadi, P, Buchman, TG, Stromberg, PE, Husain, KD, Dunne, WM, Woolsey, CA, Turnbull, IR, Hotchkiss, RS, Karl, IE, Coopersmith, CM (2004) High-dose exogenous iron following cecal ligation and puncture increases mortality rate in mice and is associated with an increase in gut epithelial and splenic apoptosis. Crit Care Med 32: pp. 1178-1185 CrossRef
  39. Heming, N, Letteron, P, Driss, F, Millot, S, Benna, J, Tourret, J, Denamur, E, Montravers, P, Beaumont, C, Lasocki, S (2012) Efficacy and toxicity of intravenous iron in a mouse model of critical care anemia. Crit Care Med 40: pp. 2141-2148 CrossRef
  
• 刊物主题：Intensive / Critical Care Medicine; Emergency Medicine;
• 出版者：BioMed Central
• ISSN：1364-8535

文摘

Introduction Prevalence of iron deficiency (ID) at intensive care (ICU) admission is around 25 to 40%. Blood losses are important during ICU stay, leading to iron losses, but prevalence of ID at ICU discharge is unknown. ID has been associated with fatigue and muscular weakness, and may thus impair post-ICU rehabilitation. This study assessed ID prevalence at ICU discharge, day 28 (D28) and six months (M6) after and its relation with fatigue. Methods We conducted this prospective, multicenter observational study at four University hospitals ICUs. Anemic (hemoglobin (Hb) less than 13聽g/dL in male and less than 12聽g/dL in female) critically ill adult patients hospitalized for at least five days had an iron profile taken at discharge, D28 and M6. ID was defined as ferritin less than 100聽ng/L or less than 300聽ng/L together with a transferrin saturation less than 20%. Fatigue was assessed by numerical scale and the Multidimensional Fatigue Inventory-20 questionnaire at D28 and M6 and muscular weakness by a hand grip test at ICU discharge. Results Among 107 patients (men 77%, median (IQR) age 63 (48 to 73) years) who had a complete iron profile at ICU discharge, 9 (8.4%) had ID. At ICU discharge, their hemoglobin concentration (9.5 (87.7 to 10.3) versus 10.2 (92.2 to 11.7) g/dL, P =0.09), hand grip strength (52.5 (30 to 65) versus 49.5 (15.5 to 67.7)% of normal value, P =0.61) and visual analog scale fatigue scale (57 (40 to 80) versus 60 (47.5 to 80)/100, P =0.82) were not different from non-ID patients. At D28 (n =80 patients) and M6 (n =78 patients), ID prevalence increased (to 25 and 35% respectively) while anemia prevalence decreased (from 100% to 80 and 25% respectively, P P =0.012). At M6, this association disappeared. Conclusions The prevalence of ID increases from 8% at discharge to 35% six months after prolonged ICU stay (more than five days). ID was associated with increased fatigue, independently of anemia, at D28.