Protocol of Heming et al for Identifying Iron Deficiency Anemia in a Critically IIl Patient

Patient selection: critically-ill patient who has not been transfused with low serum iron

Parameters:

(1) gender

(2) hemoglobin in g/dL

(3) serum iron

(4) serum ferritin (which can be an acute phase reactant)

(5) transferrin saturation

(6) C-reactive protein (CRP)

(7) hepcidin

(8) ratio of soluble (serum) transferrin receptor (sTfR) to LOG10 ferritin

Criteria for anemia:

(1) male gender AND hemoglobin < 13 g/dL

(2) female gender AND hemoglobin < 12 g/dL

Iron replacement is appropriate for iron deficiency anemia, including that masked by acute inflammation.

Anemia of inflammation may benefit from an erythropoiesis-stimulating agent (like erythropoietin).