Acute Anemia in Critical Patients: Etiological Approach and Clinical Impacts

• DOI: https://doi.org/10.22533/at.ed.159512503011

• Palavras-chave: Acute anemia; Critical care; Blood transfusion; Inflammation and anemia; ICU management

• Keywords: Acute anemia; Critical care; Blood transfusion; Inflammation and anemia; ICU management

• Abstract: INTRODUCTION Acute anemia in critically ill patients is a common and multifaceted condition, driven by factors such as systemic inflammation, gastrointestinal bleeding, nutritional deficiencies, and iatrogenic blood loss. Its pathophysiology is complex, involving disrupted erythropoiesis, iron metabolism dysfunction, and increased red blood cell destruction. Despite its high prevalence in intensive care units, the diagnostic limitations of conventional tools often delay targeted interventions, further complicating clinical management. OBJETIVE To analyze the etiologies, diagnostic challenges, and clinical implications of acute anemia in critically ill patients while evaluating the effectiveness of current management strategies. METHODS This is a narrative review which included studies in the MEDLINE – PubMed (National Library of Medicine, National Institutes of Health), COCHRANE, EMBASE and Google Scholar databases, using as descriptors: “Acute anemia” AND “Critical care” OR “Blood transfusion” OR “Inflammation and anemia” OR “ICU management” in the last 5 years. RESULTS AND DISCUSSION Results highlight the significant impact of acute anemia on oxygen delivery, organ function, and patient outcomes. Restrictive transfusion strategies have gained prominence, reducing complications associated with liberal transfusions, but their applicability remains patient-specific. Alternative therapies, such as parenteral iron supplementation and erythropoiesis-stimulating agents, show promise but are not without risks. Emerging therapies targeting inflammatory pathways and iron recycling offer potential for more effective management. However, the long-term clinical and economic consequences of untreated anemia remain a critical concern. CONCLUSION Addressing acute anemia in critical care requires a multidisciplinary approach that integrates advanced diagnostics, personalized therapies, and proactive monitoring. While current strategies provide valuable frameworks, further research is essential to close the gaps in our understanding of its pathophysiology and treatment. Optimizing the management of acute anemia in ICUs can improve patient outcomes and reduce the burden of complications in this high-risk population.