Anemia in sepsis: the importance of red blood cell membrane changes

SUMMARY Anemia is a common problem in acutely ill patients, especially in those who develop sepsis. There are many factors contributing to the development of anemia in these patients, including blood sampling and other losses, decreased red blood cell (RBC) synthesis, and possibly increased destruction. Increased RBC uptake may be due to changes in RBC morphology and the RBC membrane during inflammatory processes. In particular, a rapid increase in RBC sphericity correlated with a decreased surface carbohydrate membrane content and alterations in the lipid bilayer with increased peroxidation and phosphatidylserine exposure in the outer leaflet of the membrane. Better understanding of these alterations could facilitate new strategies to prevent the development of anemia in sepsis.