Thread: Low hemoglobin after trauma

Hello
My father has been in the ICU for 6 days since he was in a very bad accident. His hemoglobin count has been 3-4. They have been giving him EPO and albumin, as much as they can. Right now his SvO2 is averaging in the 60's his HR is 110, his CMap is above 75. He is 59. How long can his heart maintain this? Have there been any similar cases?

Sorry to hear about your father. If he was in reasonably good health going into this, he could cope with that degree of anemia for an extended period of time.

Ask about hyperbaric oxygen; see if a chamber is available nearby.
See, for example: Rubicon Research Repository: Item 123456789/7884

Thank you Dr Malak, I will definetely ask the dr's here if this is an option for my dad. It's extremely difficult to move my dad though, due to multiple fractures to his pelvis and vertabrae and broken ribs. He is in good health. His heart is strong and his lungs are clear. We are worried about brain damage because of his low oxygen levels.

I am not a doctor but I was wondering if gelatin and or iron and B12 help with this? Perhaps someone on this board would know.

My husband went thru 9 surgeries and his Hemoglobin came down to 4.9 at the lowest. They gave him Procrit weekly, starting at 20 000 unit and his last dose was 60000 units. They gave him IV Iron 5 days in a row, to try and boost the Procrit after the third week. They did notice that his marrow was not producing as many new cells like they thought it would be, so doctors decided to check his vitamin levels. Folic Acid did the trick. They also gave him Vitamin B Complex, renal friendly (Nephplex), since kidneys are the ones that produce EPO in the first place. Once they started giving it to him, he had a boost of 2 points in a matter of days and was able to transfer from intermediate care straight to Rehab. It's been 6 months but he's oficially anemia free. It took a long time, since due to poor circulation, he needs to take blood thinners everyday.

Even if your Father's vitamin levels are normal, he definitely should be on iron (preferable IV), B12, Folic acid and Vitamin C every day so his bone marrow has the necessary building blocks to product red blood cells. You might want to also see if the doctors will OK him to take Chlorophyll. I have seen great success with using it in conjuction with the above supplements. Had a patient with a hemoglobin at 3.8 who was receiving all of the above plus Procrit, but it wasn't until we added in the Chlorophyll that her counts started to go up 0.5 g/L per day. She was not nearly as health as your Father (lots of comorbidities), but she did fine.

This level of hemoglobin is too low and may cause ischemia/heart failure is left uncorrected. As Leslie mentioned, your father definitely needs iron, preferably intravenous, and the rest of the ingredients for hemoglobin. Erythropoietin and albumin are not enough. And other factors which increases oxygen consumption by the body such as fever should be managed properly.

Do you mean gelatin given IV as colloid plasma substitute? Gelatin (succinylated or polygeline) is given as plasma substitute for blood loss to prevent or treat hypovolemia. Gelatin does not contain iron so it will not help correct anemia but will help maintain near normal BP while correcting anemia.