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Extra resources for Annual Update in Intensive Care and Emergency Medicine 2014
28 L. T. van Eijk et al. Conclusion Profound changes in iron metabolism occur in critically ill patients. These changes are predominantly the result of both blood loss and the inflammatory process, and are relevant to the intensive care patient for three reasons: 1) anemia is frequently observed in critically ill patients, is associated with impaired immunity and worse outcome, and cannot be adequately compensated by transfusions or erythropoiesis – stimulating agents, whereas there might be an additive role for iron supplementation; 2) iron homeostasis may determine the fate of an infection, as iron is an essential nutrient for pathogens, and future research should, therefore, clarify the exact role of bound and unbound iron in critically ill infected patients; 3) iron can catalyze oxidative stress reactions that cause organ damage, especially when non-transferrin-bound or labile iron exists.
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