The Postinjury Inflammatory State and the Bone Marrow Response to Anemia

American Journal of Respiratory and Critical Care Medicine
Tyler J LoftusAlicia M Mohr

Abstract

The pathophysiology of persistent injury-associated anemia is incompletely understood, and human data are sparse. To characterize persistent injury-associated anemia among critically ill trauma patients with the hypothesis that severe trauma would be associated with neuroendocrine activation, erythropoietin dysfunction, iron dysregulation, and decreased erythropoiesis. A translational prospective observational cohort study comparing severely injured, blunt trauma patients who had operative fixation of a hip or femur fracture (n = 17) with elective hip repair patients (n = 22). Bone marrow and plasma obtained at the index operation were assessed for circulating catecholamines, systemic inflammation, erythropoietin, iron trafficking pathways, and erythroid progenitor growth. Bone marrow was also obtained from healthy donors from a commercial source (n = 8). During admission, trauma patients had a median of 625 ml operative blood loss and 5 units of red blood cell transfusions, and Hb decreased from 10.5 to 9.3 g/dl. Compared with hip repair, trauma patients had higher median plasma norepinephrine (21.9 vs. 8.9 ng/ml) and hepcidin (56.3 vs. 12.2 ng/ml) concentrations (both P < 0.05). Bone marrow erythropoietin and erythropoietin r...Continue Reading

References

Oct 1, 1982·Proceedings of the National Academy of Sciences of the United States of America·J van RenswoudeR D Klausner
Apr 15, 1994·Annals of the New York Academy of Sciences·W NijhofM Loeffler
Feb 1, 1997·Intensive Care Medicine·P RogiersJ L Vincent
Aug 1, 1997·Intensive Care Medicine·J F NavarroD Fuchs
May 25, 2001·Critical Care Medicine·P Hobisch-HagenW Schobersberger
Jul 12, 2001·Proceedings of the National Academy of Sciences of the United States of America·G NicolasS Vaulont
Sep 24, 2002·JAMA : the Journal of the American Medical Association·Jean Louis VincentUNKNOWN ABC (Anemia and Blood Transfusion in Critical Care) Investigators
Jun 5, 2003·The Journal of Trauma·Debra L MaloneLena M Napolitano
Aug 13, 2003·The Journal of Trauma·Marc J ShapiroM Michael Shabot
Oct 28, 2003·Annals of Surgery·David H LivingstonPranela Rameshwar
Mar 4, 2005·Surgical Infections·Rodrigo B FonsecaDavid H Livingston
Dec 24, 2005·The Journal of Trauma·Rodrigo B FonsecaDavid H Livingston
Apr 1, 2006·American Journal of Respiratory and Critical Care Medicine·Yann-Erick ClaessensAlain Cariou
Nov 14, 2006·The Journal of Trauma·Yohan RobinsonAndreas Oberholzer
Jan 26, 2007·The American Surgeon·Anthony CharlesRichard Pomerantz
Jul 17, 2007·Seminars in Hematology·Robert Möhle, Lothar Kanz
Sep 7, 2007·The New England Journal of Medicine·Howard L CorwinUNKNOWN EPO Critical Care Trials Group
Apr 19, 2008·American Journal of Respiratory and Critical Care Medicine·Scot T BatemanUNKNOWN Pediatric Acute Lung Injury and Sepsis Investigators Network
Jul 8, 2010·The Journal of Surgical Research·Angela PennDavid H Livingston
Aug 12, 2010·The Journal of Trauma·Keith A BeiermeisterAlicia M Mohr
May 17, 2011·The Journal of Surgical Research·Gregg M BaranskiAlicia M Mohr
Aug 10, 2011·The Journal of Trauma·Edward J HannoushDavid H Livingston
Jul 1, 2014·The Journal of Trauma and Acute Care Surgery·Letitia E BibleAlicia M Mohr
Apr 29, 2015·Bone Marrow Transplantation·U DeotareJ H Lipton
Jul 15, 2015·Surgery·Heather S DolmanJames G Tyburski
Dec 17, 2015·The Journal of Trauma and Acute Care Surgery·Katrina PirieErica Wood
Jul 12, 2016·The Journal of Trauma and Acute Care Surgery·Ines G AlamoAlicia M Mohr
Dec 30, 2016·American Journal of Physiology. Cell Physiology·Shirin HasanKuzhali Muthumalaiappan
Jan 19, 2017·The Journal of Trauma and Acute Care Surgery·Ines G AlamoAlicia M Mohr

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Citations

Jun 27, 2018·American Journal of Respiratory and Critical Care Medicine·Lena M Napolitano
Dec 24, 2018·Expert Review of Molecular Diagnostics·Robert DuncanBryan Lanning
Apr 9, 2019·American Journal of Respiratory and Critical Care Medicine·Ivor S DouglasHayley B Gershengorn
Aug 10, 2020·The Journal of Trauma and Acute Care Surgery·Camille G AppleAlicia M Mohr
Dec 28, 2019·The Journal of Surgical Research·Camille G AppleAlicia M Mohr
Dec 30, 2020·The Journal of Surgical Research·Getasha D DoobayAlicia M Mohr
Jun 30, 2021·The Journal of Surgical Research·Camille G AppleAlicia M Mohr
Dec 28, 2021·Surgical Infections·Camille G AppleAlicia M Mohr

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Methods Mentioned

BETA
light microscopy

Clinical Trials Mentioned

NCT02577731
NCT02047552

Software Mentioned

GraphPad
GraphPad Prism
REDCap
RED

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