Anemia in the Surgical ICU

  • Aryeh ShanderEmail author
  • Lena M. Napolitano
  • Margit Kaufman


Anemia is common in critically ill and it is associated with worsening of outcomes and increased risk of transfusion. Various compensatory mechanisms are activated to mitigate the negative effects of reduced oxygen-carrying capacity of blood in anemia, but these adaptations have limits and as the limits are reached, tissue oxygen delivery will no longer be adequate to meet the demand and ischemia and tissue injury may occur. Anemia is often multifactorial and in critically ill patients, it can be caused by blood loss, impaired erythropoiesis, and reduced life span of red blood cells, iron deficiency (absolute or functional), and hemodilution. Various management strategies are available to address these etiologies. Given the risks of transfusion, allogeneic blood should be used judiciously and only when clearly indicated and alongside other management and preventive strategies to reduce unnecessary and avoidable transfusions.


Anemia Hemoglobin Ischemia Transfusion Iron Erythropoietin 


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Authors and Affiliations

  • Aryeh Shander
    • 1
    Email author
  • Lena M. Napolitano
    • 2
  • Margit Kaufman
    • 1
  1. 1.Anesthesiology and Critical Care MedicineEnglewood Hospital and Medical CenterEnglewoodUSA
  2. 2.Department of SurgeryUniversity of Michigan Health SystemAnn ArborUSA

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