Journal article
Hepcidin predicts response to IV iron therapy in patients admitted to the intensive care unit: A nested cohort study
Journal of Intensive Care, Vol.6(1)
2018
Abstract
Background
Both anaemia and red blood cell (RBC) transfusion are common and associated with adverse outcomes in patients admitted to the intensive care unit (ICU). The aim of this study was to determine whether serum hepcidin concentration, measured early after ICU admission in patients with anaemia, could identify a group in whom intravenous (IV) iron therapy decreased the subsequent RBC transfusion requirement.
Methods
We conducted a prospective observational study nested within a multicenter randomized controlled trial (RCT) of IV iron versus placebo. The study was conducted in the ICUs of four tertiary hospitals in Perth, Western Australia. Critically ill patients with haemoglobin (Hb) of < 100 g/L and within 48 h of admission to the ICU were eligible for participation after enrolment in the IRONMAN RCT. The response to IV iron therapy compared with placebo was assessed according to tertile of hepcidin concentration.
Results
Hepcidin concentration was measured within 48 h of ICU admission in 133 patients. For patients in the lower two tertiles of hepcidin concentration (< 53.0 μg), IV iron therapy compared with placebo was associated with a significant decrease in RBC transfusion requirement [risk ratio 0.48 (95% CI 0.26–0.85), p = 0.013].
Conclusions
In critically ill patients with anaemia admitted to an ICU, baseline hepcidin concentration predicts RBC transfusion requirement and is able to identify a group of patients in whom IV iron compared with placebo is associated with a significant decrease in RBC transfusion requirement.
Details
- Title
- Hepcidin predicts response to IV iron therapy in patients admitted to the intensive care unit: A nested cohort study
- Authors/Creators
- E. Litton (Author/Creator) - Fiona Stanley HospitalS. Baker (Author/Creator) - Sir Charles Gairdner HospitalW. Erber (Author/Creator) - The University of Western AustraliaS. Farmer (Author/Creator) - The University of Western AustraliaJ. Ferrier (Author/Creator) - Fiona Stanley HospitalC. French (Author/Creator) - The University of MelbourneJ. Gummer (Author/Creator)D. Hawkins (Author/Creator) - Intensive Care Unit, Joondalup Health Campus, Joondalup, AustraliaA. Higgins (Author/Creator) - Monash UniversityA. Hofmann (Author/Creator) - The University of Western AustraliaB. De Keulenaer (Author/Creator) - Fiona Stanley HospitalJ. McMorrow (Author/Creator) - Royal Perth HospitalJ.K. Olynyk (Author/Creator) - The University of Western AustraliaT. Richards (Author/Creator) - UCL AustraliaS. Towler (Author/Creator) - Fiona Stanley HospitalR. Trengove (Author/Creator) - Murdoch UniversityS. Webb (Author/Creator) - Royal Perth Hospital
- Publication Details
- Journal of Intensive Care, Vol.6(1)
- Publisher
- BioMed Central Ltd
- Identifiers
- 991005543599007891
- Copyright
- © 2018 The Author(s).
- Murdoch Affiliation
- Separation Science and Metabolomics Laboratory
- Language
- English
- Resource Type
- Journal article
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- Collaboration types
- Domestic collaboration
- International collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.184 Physiology & Metals
- 1.184.573 Iron Metabolism
- Web Of Science research areas
- Critical Care Medicine
- ESI research areas
- Clinical Medicine