Hematologic Challenges in Anesthesiology and Critical Care

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Critical Care".

Deadline for manuscript submissions: closed (30 June 2024) | Viewed by 9027

Special Issue Editors


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Guest Editor
1. Department of Anaesthesiology and Intensive Care, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
2. Transfusion Committee, University Clinical Centre of Medical University of Silesia in Katowice, Medyków 14, 40-752 Katowice, Poland
Interests: anemia in septic patients in the ICU; hospital-acquired anemia in the ICU; red blood cell transfusion in the critically ill; coagulopathy; rotational thromboelastography; hematologic diseases managed in the ICU; patient blood management; sepsis; fluid therapy; acute kidney injury

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Guest Editor
Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA, USA
Interests: sepsis; outcome; recovery; epigenetic; post-ICU syndrome; extra-corporeal membrane oxygenation; immunoparalysis; anergy; behavioral economic; medical decision making; intensive care; medicine in austere settings
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Special Issue Information

Dear Colleagues,

Hematological disorders constitute a daily challenge for clinicians providing care in the fields of anesthesiology and critical care. Hematological problems are common in patients scheduled for surgery or hospitalized in the intensive care unit (ICU), span wide range of disorders, and present with diagnostic and management difficulties. The most frequent hematological disease encountered preoperatively and during critical illness is anemia. Anemia is present in 66% of patients at the moment of ICU admission, and in nearly 95% of patients after 72 h of ICU hospitalization. Although anemia is ubiquitous among these patients, its management is often neglected, and anemia itself is viewed by clinicians as a consequence of the primary clinical problem, not as a disease entity of its own. Red blood cell (RBC) transfusion decision-making in critically ill patients is an area of debate. Clinical consequences of RBC transfusion have been researched in recent years. Other hematological issues encountered in these patients include coagulopathies of various etiology: trauma, bleeding, acute liver injury, extracorporeal-circuit-induced hematological issues, drug-induced hematological issues, etc. The unresolved issues regarding the diagnosis and management of various coagulopathies in anesthesiology and critical care patients deserve further research in the field. Timely etiologic classification and optimal management of hematological diseases constitute foundation of patient blood management programs, the benefits of which are particularly seen in the pre-surgical setting and in the ICU. All these factors underline the importance of devoting a Special Issue to the topic of hematologic challenges in anesthesiology and critical care. We warmly invite researchers in the field to contribute to this Special Issue of Healthcare.

Dr. Piotr F. Czempik
Dr. Krzysztof Laudanski
Guest Editors

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Keywords

  • anemia
  • red blood cell transfusion
  • sepsis-induced coagulopathy
  • trauma-induced coagulopathy
  • disseminated intravascular coagulation
  • thrombotic thrombocytopenic purpura
  • therapeutic plasma exchange
  • bleeding
  • anticoagulation
  • hematologic testing

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Published Papers (2 papers)

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Research

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10 pages, 531 KiB  
Article
Comparison of Standard and New Iron Status Biomarkers: A Prospective Cohort Study in Sepsis Patients
by Piotr F. Czempik and Agnieszka Wiórek
Healthcare 2023, 11(7), 995; https://doi.org/10.3390/healthcare11070995 - 30 Mar 2023
Cited by 3 | Viewed by 1947
Abstract
Both iron deficiency (ID) and iron overload can have negative effects on the risk and course of infection. Therefore, the ability to accurately assess iron status in these patients is of the utmost importance. Systemic inflammation in sepsis patients affects the results of [...] Read more.
Both iron deficiency (ID) and iron overload can have negative effects on the risk and course of infection. Therefore, the ability to accurately assess iron status in these patients is of the utmost importance. Systemic inflammation in sepsis patients affects the results of standard iron biomarkers and makes accurate diagnosis of ID problematic. The aim of our study was to analyze the association between widely available standard iron biomarkers and selected new iron biomarkers in various iron status subgroups among sepsis patients. Consecutive patients diagnosed with sepsis or septic shock and procalcitonin concentration > 0.5 ng/mL were enrolled. The following iron biomarkers were determined: iron, ferritin, transferrin, transferrin saturation, reticulocyte (Ret) number and percentage, Ret hemoglobin equivalent, Ret fluorescence subpopulations, and hepcidin concentration. The study group comprised 90 study subjects. There were 42 (47%) patients with normal iron status, 6 (6%) with ID without anemia, and 42 (47%) with ID anemia. No meaningful correlation exists between standard and new iron biomarkers in various iron status subgroups among sepsis patients. Therefore, standard iron biomarkers cannot be used to diagnose ID in this cohort. Full article
(This article belongs to the Special Issue Hematologic Challenges in Anesthesiology and Critical Care)
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Review

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13 pages, 535 KiB  
Review
Management Strategies in Septic Coagulopathy: A Review of the Current Literature
by Piotr F. Czempik and Agnieszka Wiórek
Healthcare 2023, 11(2), 227; https://doi.org/10.3390/healthcare11020227 - 12 Jan 2023
Cited by 6 | Viewed by 6235
Abstract
One of the ‘organs’ that can be affected by sepsis is the coagulation system. Coagulopathy in sepsis may take the form of sepsis-induced coagulopathy (SIC) or sepsis-associated disseminated intravascular coagulation (DIC). It is important to identify SIC early, as at this stage of [...] Read more.
One of the ‘organs’ that can be affected by sepsis is the coagulation system. Coagulopathy in sepsis may take the form of sepsis-induced coagulopathy (SIC) or sepsis-associated disseminated intravascular coagulation (DIC). It is important to identify SIC early, as at this stage of coagulopathy anticoagulants may be of the greatest benefit. The most recent diagnostic scoring systems for septic coagulopathy come from the International Society on Thrombosis and Hemostasis and the Japanese Association for Acute Medicine. Recommendations regarding the management of septic coagulopathy differ between organizations. Moreover, septic coagulopathy is an area of intense research in recent years. Therefore we searched three databases to review the most recent management strategies in septic coagulopathy. The mainstream management strategies in septic coagulopathy include the causal treatment of sepsis, unfractionated heparin, low-molecular-weight heparin, antithrombin, and recombinant human thrombomodulin. The last two have been associated with the highest survival benefit. Nevertheless, the indiscriminate use of these anticoagulants should be avoided due to the lack of mortality benefit and increased risk of bleeding. The early diagnosis of SIC and monitoring of coagulation status during sepsis is crucial for the timely management and selection of the most suitable treatment at a time. New directions in septic coagulopathy include new diagnostic biomarkers, dynamic diagnostic models, genetic markers for SIC management, and new therapeutic agents. These new research avenues may potentially result in timelier SIC diagnosis and improved management of all stages of septic coagulopathy by making it more effective, safe, and personalized. Full article
(This article belongs to the Special Issue Hematologic Challenges in Anesthesiology and Critical Care)
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