Improved Diagnosis of Iron Deficiency Anemia in the Critically Ill via Fluorescence Flowcytometric Hemoglobin Biomarkers
Background: Iron deficiency anemia (IDA) is common in critically ill patients treated in the intensive care unit (ICU), and it can lead to severe consequences. Precise and immediate diagnostics are not available, but they are inevitably needed to administer adequate therapy. Serological parameters s...
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MDPI AG
2022-12-01
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| Online Access: | https://www.mdpi.com/2073-4409/12/1/140 |
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| author | Mascha Zuther Marie-Luise Rübsam Mathias Zimmermann Alexander Zarbock Christian Hönemann |
| author_facet | Mascha Zuther Marie-Luise Rübsam Mathias Zimmermann Alexander Zarbock Christian Hönemann |
| author_sort | Mascha Zuther |
| collection | DOAJ |
| description | Background: Iron deficiency anemia (IDA) is common in critically ill patients treated in the intensive care unit (ICU), and it can lead to severe consequences. Precise and immediate diagnostics are not available, but they are inevitably needed to administer adequate therapy. Serological parameters such as serum ferritin and transferrin saturation (TSAT) are heavily influenced by simultaneous inflammation reactions, resulting in the need for more suitable parameters. Reticulocyte biomarkers such as reticulocyte hemoglobin content (RET-H<i>e</i>) and Delta-hemoglobin equivalent (Delta-H<i>e</i>) determined by fluorescence flowcytometry are more specific for the diagnosis of IDA-based anemia and should be investigated for this purpose. Methods: In a prospective cohort single-center study, serum ferritin and transferrin saturation (TSAT) were collected and compared to RET-H<i>e</i> and Delta-H<i>e</i> by performing a receiver operating curve (ROC) analysis. The sensitivity and specificity of a single variable or the combination of two variables, as well as cutoff values, for the diagnosis of IDA were calculated. A group comparison for IDA patients without IDA was performed for a control group. Results: A total of 314 patients were enrolled from an interdisciplinary ICU. RET-H<i>e</i> (area under the curve (AUC) 0.847) and Delta-H<i>e</i> (AUC 0.807) did indicate iron-deficient anemia that was more specific and sensitive in comparison to serum ferritin (AUC 0.678) and TSAT (AUC 0.754). The detection of functional iron deficiency (FID) occurred in 28.3% of cases with anemia. Conclusions: Determination of RET-H<i>e</i> and Delta-H<i>e</i> allows for the increased precision and sensitivity of iron-deficient anemia in the ICU. |
| first_indexed | 2024-03-11T10:04:49Z |
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| language | English |
| last_indexed | 2024-03-11T10:04:49Z |
| publishDate | 2022-12-01 |
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| series | Cells |
| spelling | doaj.art-4dc8c900eedb412897eab4083ad794962023-11-16T15:06:39ZengMDPI AGCells2073-44092022-12-0112114010.3390/cells12010140Improved Diagnosis of Iron Deficiency Anemia in the Critically Ill via Fluorescence Flowcytometric Hemoglobin BiomarkersMascha Zuther0Marie-Luise Rübsam1Mathias Zimmermann2Alexander Zarbock3Christian Hönemann4Klinik für Anästhesiologie, Operative Intensivmedizin und Schmerztherapie, Universitätsklinikum Münster, 48149 Münster, GermanyKlinik für Anästhesiologie, Intensiv-, Notfall- und Schmerzmedizin, Universitätsmedizin Greifswald, 17475 Greifswald, GermanyInstitut für Labormedizin Köpenick, DRK Kliniken Berlin, 12559 Berlin, GermanyKlinik für Anästhesiologie, Operative Intensivmedizin und Schmerztherapie, Universitätsklinikum Münster, 48149 Münster, GermanyKlinik für Anästhesiologie, Operative Intensivmedizin und Schmerztherapie, Universitätsklinikum Münster, 48149 Münster, GermanyBackground: Iron deficiency anemia (IDA) is common in critically ill patients treated in the intensive care unit (ICU), and it can lead to severe consequences. Precise and immediate diagnostics are not available, but they are inevitably needed to administer adequate therapy. Serological parameters such as serum ferritin and transferrin saturation (TSAT) are heavily influenced by simultaneous inflammation reactions, resulting in the need for more suitable parameters. Reticulocyte biomarkers such as reticulocyte hemoglobin content (RET-H<i>e</i>) and Delta-hemoglobin equivalent (Delta-H<i>e</i>) determined by fluorescence flowcytometry are more specific for the diagnosis of IDA-based anemia and should be investigated for this purpose. Methods: In a prospective cohort single-center study, serum ferritin and transferrin saturation (TSAT) were collected and compared to RET-H<i>e</i> and Delta-H<i>e</i> by performing a receiver operating curve (ROC) analysis. The sensitivity and specificity of a single variable or the combination of two variables, as well as cutoff values, for the diagnosis of IDA were calculated. A group comparison for IDA patients without IDA was performed for a control group. Results: A total of 314 patients were enrolled from an interdisciplinary ICU. RET-H<i>e</i> (area under the curve (AUC) 0.847) and Delta-H<i>e</i> (AUC 0.807) did indicate iron-deficient anemia that was more specific and sensitive in comparison to serum ferritin (AUC 0.678) and TSAT (AUC 0.754). The detection of functional iron deficiency (FID) occurred in 28.3% of cases with anemia. Conclusions: Determination of RET-H<i>e</i> and Delta-H<i>e</i> allows for the increased precision and sensitivity of iron-deficient anemia in the ICU.https://www.mdpi.com/2073-4409/12/1/140reticulocyte parametersanemiairon deficiencyfunctional iron deficiencyreticulocyte hemoglobin content (RET-H<i>e</i>)intensive care |
| spellingShingle | Mascha Zuther Marie-Luise Rübsam Mathias Zimmermann Alexander Zarbock Christian Hönemann Improved Diagnosis of Iron Deficiency Anemia in the Critically Ill via Fluorescence Flowcytometric Hemoglobin Biomarkers Cells reticulocyte parameters anemia iron deficiency functional iron deficiency reticulocyte hemoglobin content (RET-H<i>e</i>) intensive care |
| title | Improved Diagnosis of Iron Deficiency Anemia in the Critically Ill via Fluorescence Flowcytometric Hemoglobin Biomarkers |
| title_full | Improved Diagnosis of Iron Deficiency Anemia in the Critically Ill via Fluorescence Flowcytometric Hemoglobin Biomarkers |
| title_fullStr | Improved Diagnosis of Iron Deficiency Anemia in the Critically Ill via Fluorescence Flowcytometric Hemoglobin Biomarkers |
| title_full_unstemmed | Improved Diagnosis of Iron Deficiency Anemia in the Critically Ill via Fluorescence Flowcytometric Hemoglobin Biomarkers |
| title_short | Improved Diagnosis of Iron Deficiency Anemia in the Critically Ill via Fluorescence Flowcytometric Hemoglobin Biomarkers |
| title_sort | improved diagnosis of iron deficiency anemia in the critically ill via fluorescence flowcytometric hemoglobin biomarkers |
| topic | reticulocyte parameters anemia iron deficiency functional iron deficiency reticulocyte hemoglobin content (RET-H<i>e</i>) intensive care |
| url | https://www.mdpi.com/2073-4409/12/1/140 |
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