@article{js2019713,
author={{Smits, Michael and Hart, Colby and Sivarajah, Gausihi and Radojcic, Matija and Abbas, Saleh},
title={Anaemia in Surgical Sepsis and Stress: The Roles of Erythropoietin, Iron and Steroids},
journal={Global Journal of Surgery},
volume={7},
number={1},
pages={12--18},
year={2019},
url={http://pubs.sciepub.com/js/7/1/3},
issn={2379-8750},
abstract={<b>Background:</b> Inflammation in surgical sepsis and stress frequently causes anaemia, leading to increased rates of blood transfusions. Recent evidence shows that blood transfusions carry a greater risk for short- and long-term complications than previously thought. <b>Objective:</b> To review the role of erythropoietin (EPO), iron and/or steroids as an alternative treatment to blood transfusions in critically ill patients. <b>Methodology:</b> A systematic review was prepared from recent literature on inflammation-induced anaemia, anaemia in the critically ill and/or septic patient and the roles of EPO, iron and corticosteroids in these patients. A meta-analysis was completed for EPO. <b>Results:</b> Inflammatory cytokines alter haematopoietic and biochemical pathways, leading to anaemia. Inflammation decreases circulating EPO and upregulates hepcidin, resulting in decreased free iron. Twelve randomised-controlled trials demonstrate that EPO administration in critically ill patients reduces the need for blood transfusions by 31% (p=0.005) however does not significantly decrease mortality (p=0.15). Intravenous iron also reduces the need for blood transfusions but has not been utilised in sepsis-associated anaemia. No trials focusing on the effects of steroids on sepsis-associated anaemia were identified. <b>Conclusion:</b> Due to the lack of data specific to sepsis-associated anaemia in post-operative patients, the roles of EPO, iron and steroids remain under investigation. More research specific to surgical patients is needed.},
doi={10.12691/js-7-1-3}
publisher={Science and Education Publishing}
}