Cell-free hemoglobin is increasingly playing a more central role in the pathogenesis of sepsis being proved to be a potent predictor of patient's outcome. It is crucial, hence, to further investigate the mechanisms of sepsis-induced hemolysis with the aim of deriving possible therapeutic principles. Herein, we collected the most important previously known triggers of hemolysis during sepsis, which are (1) transfusion reactions and complement activation, (2) disseminated intravascular coagulation, (3) capillary stopped-flow, (4) restriction of glucose to red blood cells, (5) changes in red blood cell membrane properties, (6) hemolytic pathogens, and (7) red blood cell apoptosis. Graphical Abstract ᅟ.
Keywords: disseminated intravascular coagulation; erythrocytes; hemolysis; lipopolysaccharide; pore formation; sepsis; systemic inflammation; transfusion reactions.