Iron deficiency in critically ill patients: highlighting the role of hepcidin

Excerpt

Iron is a paradoxical element, essential for living organsms but also potentially toxic. Indeed, iron has the ability to readily accept and donate electrons, interconverting from soluble ferrous form (Fe²⁺) to the insoluble ferric form (Fe³⁺). This capacity allows iron to play a major role in oxygen transport (as the central part of hemoglobin) but also in electron transfer, nitrogen fixation or DNA synthesis, all essential reactions for living organisms. Indeed, iron deficiency is the main cause of anemia [1] as well as a cause of fatigue [2, 3] and decreased effort capacity [4, 5]. However, despite a high frequency of anemia among critically ill patients, with 60 to 66% being anemic at intensive care unit (ICU) admission [6, 7], to date little is known about iron deficiency and iron metabolism in critically ill patients [8]. The interaction between inflammation and iron metabolism interferes with the usual iron metabolism variables and renders this metabolism difficult to investigate [9, 10]. …