Yıl: 2022 Cilt: 32 Sayı: 4 Sayfa Aralığı: 239 - 245 Metin Dili: İngilizce DOI: 10.4999/uhod.226429 İndeks Tarihi: 02-06-2023

Iatrogenic Anemia in Covid-19 Patients Admitted to the Intensive Care Unit

Öz:
During intensive care unit (ICU) management of COVID-19, blood tests are often conducted for close monitoring of patients, a poor prognostic factor for survival, especially in hypoxemic patients. This study aimed to determine the degree of anemia and its effect on prognosis in ICU COVID-19 patients. This retrospective study included COVID-19 patients admitted to the ICU between 1 October 2020 and 1 May 2021. All the patients included were aged > 18 years and stayed in the ICU for ≥14 days. Patients aged <18 years, those with major bleeding, and those recovering from surgery were excluded. The total blood samples (mL) taken in the ICU were calculated. From among the 395 patients screened for inclusion, 112 patients were included in the study. Mean age of the patients was 71.3 ± 13.2 years (Male/Female: 1.8). Mean hemoglobin (Hb) at admission was 13.2 ± 1.8 g dL–1. At the end of the ICU stay mean Hb was 9.74 ± 1.98 g dL–1. During ICU stay, the mean reduction in Hb was 3.47 ± 2.11 g dL–1. Age (p= 0.049), drawn blood volume per day (p= 0.001), and higher hemoglobin at admission (p= 0.001) were determined by multivariate analysis as independent risk factors for hemoglobin reduction. Hemoglobin reduction (OR: 1.34), and intubation status (OR: 57.50) were independent risk factors for mortality. Considering that most COVID-19 patients are admitted to the ICU due to acute respiratory failure (ARF), it is vital to maintain the Hb level as high as possible, so as to maintain oxygenation.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. World Health Organization Coronavirus (COVID-19) Dash- board. https://covid19.who.int (Access date: 18/01/2022).
  • 2. Gallo Marin B, Aghagoli G, Lavine K, et al. Predictors of COVID-19 severity: A literature review. Rev Med Virol 31: 1-10, 2021.
  • 3. Hayden SJ, Albert TJ, Watkins TR, Swenson ER. Anemia in critical illness: insights into etiology, consequences, and management. Am J Respir Crit Care Med. 185: 1049-1057, 2012.
  • 4. Vincent JL, Baron J-F, Reinhart K, et al. Anemia and blood transfusion in critically ill patients. JAMA 288: 1499-507, 2002.
  • 5. Corwin HL, Parsonnet KC, Gettinger A. RBC transfusion in the ICU: is there a reason? Chest 108: 767-771, 1995.
  • 6. Khamiees M, Raju P, DeGirolamo A et al. Predictors of extubation outcome in patients who have successfully completed a spontaneous breathing trial. Chest 120: 1262- 1270, 2001
  • 7. Thygesen K, Alpert JS, White H, Joint E. ACC/AHA/WHF Task Force for the Redefinition of Myocardial Infarction. Universal definition of myocardial infarction. Eur Heart J 28: 2525-2538, 2007.
  • 8. Carson JL, Noveck H, Berlin JA, Gould SA. Mortality and morbidity in patients with very low postoperative Hb levels who decline blood transfusion. Transfusion 42: 812-818, 2002.
  • 9. Jackson Chornenki NL, James TE, Barty R, et al. Blood loss from laboratory testing, anemia, and red blood cell transfusion in the intensive care unit: a retrospective study. Transfusion 60: 256-261, 2020.
  • 10. WHO. Haemoglobin concentrations for the diagnosis of anemia and assessment of severity. Vitamin and Min - eral Nutrition Information System. Geneva, World Health Organization,2011(WHO/NMH/NHD/MNM/11.1)(http:// www.who.int/vmnis/indicators/haemoglobin. pdf (Access date: 18/01/2022).
  • 11. Beverina I, Borotto E, Novelli C, et al. Iatrogenic anaemia and transfusion thresholds in ICU patients with COVID-19 disease at a tertiary care hospital. Transfus Apher Sci 60: 103068, 2021.
  • 12. Corwin HL, Gettinger A, Pearl RG, et al. The CRIT Study: anemia and blood transfusion in the critically ill-current clinical practice in the United States. Crit Care Med 32: 39- 52, 2004.
  • 13. Gerth A, Hatch R, Young J, Watkinson P. Changes in health-related quality of life after discharge from an inten - sive care unit: a systematic review. Anaesthesia 74: 100- 108, 2019.
  • 14. Warner MA, Kor DJ, Frank RD, et al. Anemia in critically ill patients with acute respiratory distress syndrome and posthospitalization physical outcomes. J. Intensive Care Med. 36: 557-565, 2021.
  • 15. DeAngelo AJ, Bell DG, Quinn MW, et al. Erythropoietin re - sponse in critically ill mechanically ventilated patients: a prospective observational study. Crit Care 9: 1-5, 2005.
  • 16. Litton E, Lim J. Iron metabolism: an emerging therapeutic target in critical illness. Annual Update in Intensive Care and Emergency Medicine, 573-584, 2019.
  • 17. Bodley T, Chan M, Levi O, et al. Patient harm associated with serial phlebotomy and blood waste in the intensive care unit: A retrospective cohort study. PloS One 16: e0243782, 2021
  • 18. Van der Laan S, Billah T, Chi C, et al. Anaemia among in - tensive care unit survivors and association with days alive and at home: an observational study. Anaesthesia 76: 1352-1357, 2021.
  • 19. Grasselli G, Greco M, Zanella A, et al. Risk factors associ - ated with mortality among patients with COVID-19 in inten- sive care units in Lombardy, Italy. JAMA Intern Med 180: 1345-1355, 2020.
  • 20. Dhingra R, Vasan RS. Age as a risk factor. Med Clin 96: 87-91, 2012.
  • 21. De Winter C, Bastiaanse L, Hilgenkamp T, et al. Cardio - vascular risk factors (diabetes, hypertension, hypercholes- terolemia and metabolic syndrome) in older people with intellectual disability: results of the HA-ID study. Res Dev Disabil 33: 1722-31, 2012.
  • 22. Araya S, Wordofa M, Mamo MA, et al. The Magnitude of Hematological Abnormalities Among COVID-19 Patients in Addis Ababa, Ethiopia. J Multidiscip Healthc 14: 545, 2021.
  • 23. Tao Z, Xu J, Chen W, et al. Anemia is associated with se - vere illness in COVID-19: a retrospective cohort study. J Med Virol. 93: 1478-88, 2021.
  • 24. Whitehead NS, Williams LO, Meleth S, et al. Interventions to prevent iatrogenic anemia: a Laboratory Medicine Best Practices systematic review. Crit Care 23: 1-11, 2019.
  • 25. Baron D, Franchini M, Goobie S, et al. Patient blood man - agement during the COVID–19 pandemic: a narrative re - view. Anaesthesia 75: 1105-1113, 2020.
  • 26. Dolman HS, Evans K, Zimmerman LH, et al. Impact of minimizing diagnostic blood loss in the critically ill. Surgery 158: 1083-1088, 2015.
  • 27. Mukhopadhyay A, See K, Chan Y et al. Effect of a blood conservation device in patients with preserved admission haemoglobin in the intensive care unit. Anaesth Intensive Care 39: 426-430, 2011.
  • 28. Mahieu L, Marien A, De Dooy J et al. Implementation of a multi-parameter Point-of-Care-blood test analyzer reduces central laboratory testing and need for blood transfusions in very low birth weight infants. Clin Chim Acta 413: 325- 330, 2012.
  • 29. Cismondi F, Celi LA, Fialho AS, et al. Reducing unneces - sary lab testing in the ICU with artificial intelligence. Int J Med Inform 82: 345-358, 2013.
APA karcıoğlu o, Karcioglu A, Gokcinar D (2022). Iatrogenic Anemia in Covid-19 Patients Admitted to the Intensive Care Unit. , 239 - 245. 10.4999/uhod.226429
Chicago karcıoğlu oğuz,Karcioglu Ayse Muge,Gokcinar Derya Iatrogenic Anemia in Covid-19 Patients Admitted to the Intensive Care Unit. (2022): 239 - 245. 10.4999/uhod.226429
MLA karcıoğlu oğuz,Karcioglu Ayse Muge,Gokcinar Derya Iatrogenic Anemia in Covid-19 Patients Admitted to the Intensive Care Unit. , 2022, ss.239 - 245. 10.4999/uhod.226429
AMA karcıoğlu o,Karcioglu A,Gokcinar D Iatrogenic Anemia in Covid-19 Patients Admitted to the Intensive Care Unit. . 2022; 239 - 245. 10.4999/uhod.226429
Vancouver karcıoğlu o,Karcioglu A,Gokcinar D Iatrogenic Anemia in Covid-19 Patients Admitted to the Intensive Care Unit. . 2022; 239 - 245. 10.4999/uhod.226429
IEEE karcıoğlu o,Karcioglu A,Gokcinar D "Iatrogenic Anemia in Covid-19 Patients Admitted to the Intensive Care Unit." , ss.239 - 245, 2022. 10.4999/uhod.226429
ISNAD karcıoğlu, oğuz vd. "Iatrogenic Anemia in Covid-19 Patients Admitted to the Intensive Care Unit". (2022), 239-245. https://doi.org/10.4999/uhod.226429
APA karcıoğlu o, Karcioglu A, Gokcinar D (2022). Iatrogenic Anemia in Covid-19 Patients Admitted to the Intensive Care Unit. Uluslararası Hematoloji-Onkoloji Dergisi, 32(4), 239 - 245. 10.4999/uhod.226429
Chicago karcıoğlu oğuz,Karcioglu Ayse Muge,Gokcinar Derya Iatrogenic Anemia in Covid-19 Patients Admitted to the Intensive Care Unit. Uluslararası Hematoloji-Onkoloji Dergisi 32, no.4 (2022): 239 - 245. 10.4999/uhod.226429
MLA karcıoğlu oğuz,Karcioglu Ayse Muge,Gokcinar Derya Iatrogenic Anemia in Covid-19 Patients Admitted to the Intensive Care Unit. Uluslararası Hematoloji-Onkoloji Dergisi, vol.32, no.4, 2022, ss.239 - 245. 10.4999/uhod.226429
AMA karcıoğlu o,Karcioglu A,Gokcinar D Iatrogenic Anemia in Covid-19 Patients Admitted to the Intensive Care Unit. Uluslararası Hematoloji-Onkoloji Dergisi. 2022; 32(4): 239 - 245. 10.4999/uhod.226429
Vancouver karcıoğlu o,Karcioglu A,Gokcinar D Iatrogenic Anemia in Covid-19 Patients Admitted to the Intensive Care Unit. Uluslararası Hematoloji-Onkoloji Dergisi. 2022; 32(4): 239 - 245. 10.4999/uhod.226429
IEEE karcıoğlu o,Karcioglu A,Gokcinar D "Iatrogenic Anemia in Covid-19 Patients Admitted to the Intensive Care Unit." Uluslararası Hematoloji-Onkoloji Dergisi, 32, ss.239 - 245, 2022. 10.4999/uhod.226429
ISNAD karcıoğlu, oğuz vd. "Iatrogenic Anemia in Covid-19 Patients Admitted to the Intensive Care Unit". Uluslararası Hematoloji-Onkoloji Dergisi 32/4 (2022), 239-245. https://doi.org/10.4999/uhod.226429