Robinson Yohan, Hostmann Arwed, Matenov Alexander, Ertel Wolfgang, Oberholzer Andreas
Department of Trauma and Reconstructive Surgery, Charité - Campus Benjamin Franklin, Berlin, Germany.
J Trauma. 2006 Nov;61(5):1285-91. doi: 10.1097/01.ta.0000240969.13891.9b.
Posttraumatic anemia in multiply injured patients is caused by hemorrhage, reduced red blood cell survival, and impaired erythropoiesis. Trauma-induced hyperinflammation causes impaired bone-marrow function by means of blunted erythropoietin (EPO) response, reduced iron availability, suppression and egress of erythroid progenitor cells. To treat posttraumatic anemia in severely injured patients, symptomatic therapy by blood transfusion is not sufficient. Furthermore, EPO, iron, and the use of red cell substitutes should be considered. The posttraumatic systemic inflammatory response syndrome (SIRS) induces posttraumatic anemia. Thus, a worsening of SIRS by a "second-hit" through blood transfusion ought to be avoided.
多发伤患者的创伤后贫血是由出血、红细胞存活时间缩短和红细胞生成受损引起的。创伤诱导的过度炎症通过促红细胞生成素（EPO）反应减弱、铁供应减少、红系祖细胞的抑制和流出导致骨髓功能受损。对于重伤患者的创伤后贫血治疗，仅靠输血进行对症治疗是不够的。此外，应考虑使用EPO、铁剂以及红细胞替代物。创伤后全身炎症反应综合征（SIRS）可诱发创伤后贫血。因此，应避免输血造成的“二次打击”导致SIRS恶化。
