Biochemical markers of the iron metabolism and their relationship with the inflammatory status in multiple trauma patients
© BioMed Central Ltd 2008
Published: 13 March 2008
Anaemia is a common problem in critically ill patients. The pathophysiology of anaemia involves altered iron metabolism and impaired erythropoiesis. In this study we compared the iron metabolism in septic and nonseptic patients on admission and during their stay in the ICU.
Sixty polytrauma patients under mechanical ventilation were studied, 34 septic patients (Group I) and 26 nonseptic patients (Group II). The mean age of all patients was 51 ± 19 years, APACHE II score 13 ± 6, ISS 24 ± 11, and the mean ICU stay 25 ± 8 days. Blood samples were collected on admission, on the 7th day or the day of the onset of sepsis, and on the 15th day, and were tested for serum iron (Fe), ferritin (Ft), transferrin (Tf), and soluble transferrin receptor (sTfR). The measured inflammatory parameters were white blood cell count, C-reactive protein and procalcitonin. Statistical analysis involved Student's t test and linear regression analysis.
In Group I the mean values were Fe 22 μg/dl (12–78), Ft 877 ng/dl (85–4,797), and Tf 128 mg/dl (61–212). In group II the mean values were Fe 43 μg/dl (23–97), Ft 377 ng/dl (36–1,127) and Tf 151 mg/dl (69–216). There was a statistical difference between the two groups (P < 0.05). No difference was observed for sTfR: 1.08 mg/dl (0.44–2.16) vs 0.94 mg/dl (0.6–1.49) between the two groups. No correlation could be established between any of the markers of the iron metabolism and the patient outcome. For all patients C-reactive protein was weakly correlated with Ft (r = 0.43, P < 0.001) and inversely with Tf (r = -0.39, P < 0.001).
The iron metabolism is altered in patients who develop sepsis in the ICU but this does not seem to outline patient outcome.
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