Anemia of inflammation: features, the necessity for and possibility of correction (literature review)

Yu.P. Orlov1, N.V. Govorova1, Yu.A. Nochnaja1, V.A. Rudnov2

1 Omsk State Medical University of the Ministry of health of Russia

2 Ural State Medical University of Ministry of health of Russia

For correspondence: Yuriy P. Orlov, Dr. Med. Sci., Professor of Anesthesiology and reanimatology FGBOU in Omsk State Medical University of the Ministry of health, Omsk; e-mail:

For citation: Orlov YuP, Govorova NV, Nochnaja YuA, Rudnov VA. Anemia of inflammation: features, the necessity for and possibility of correction (literature review). Alexander Saltanov Intensive Care Herald. 2019;1:20–35.

DOI: 10.21320/1818-474X-2019-1-20-35


The purpose for writing this review. Analysis of publications in search engines about physiological and pathological iron metabolism, pathogenesis of anemia of inflammation that develops in patients in the ICU, to determine possible indications and contraindications for therapeutic intervention.

Methods. Analyzed articles in the medical literature databases, Pubmed, Medline, and EMBASE. The search strategy used for keyword: “anemia of inflammation”, “iron and infection, anaemia and sepsis”, “free hemoglobin, iron Exchange” in the period from 1990 up to 2018, inclusive and affordable domestic work (e-library) literature. The materials used by the worldʼs leading organizations World Health Organization, the Cochrane Reviews, WSACS, ARDS ARTS CENTRE Clinical Trials Network, European Society of Intensive Care Medicine, European Society of Anesthesiologists, Society of Critical Care Medicine.

Conclusion. Anemia as a symptom, in critical condition in the first place, requires a definition of its role in the genesis of hypoxia. This should be supported by not only hemoglobin levels, as a carrier of oxygen and hypoxia specific criteria: analysis of blood gases, assess the height of tooth ST according to ECG and, of course, blood lactate level (more than 2 mmol/l). Anemia when sepsis is caused by intravascular hemolysis and gipoferremija is a consequence of natural compensatory protection from possible manifestations of infection. The introduction of such patients with iron or blood donations entail access to iron bacteria. In the context of sepsis and continuing to use the hemolysis chelators, if revealed high levels of ferritin, low concentration of gaptoglobina and transferrin. Decision on blood transfusion or iron supplementation should be individualized, taking into account the specific factors of the patient, and any potential benefits of therapy drugs iron should.

Keywords: anemia of inflammation, iron, iron metabolism

Received: 24.12.2018

Accepted: 01.03.2019


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