2008, Number 1
<< Back Next >>
Med Sur 2008; 15 (1)
Transfusions in the Service Intensive Care Medica Sur Clinic & Foundation. Trends in five years
Remolina SM
Language: Spanish
References: 21
Page: 24-29
PDF size: 110.42 Kb.
ABSTRACT
We present all cases that have received transfusions during their stay in the ICU of the Medica Sur Hospital and Foundation during a five-year period. We present totals, means per patient, by year, differences among surgical and medical cases in the ICU and the rest of the hospital and the trends during this period. In total 706 cases of 1,380 ICU patients (51%) received a mean of 9.42 units per patient (u/p)
vs 3.23 u/p transfused in the rest of the hospital. Medical cases (30%) received a mean of 8.15 u/p (1-130 u) (total 1,761 u) and the surgical cases (70%) received 9.98 u/p (1-200 u) (total 4,884 u). We report a decrease in the mean transfusion rate in the ICU from 15.1 u/p to 6.3 u/p in comparison to little change in the rest of the hospital. There were differences every year and with statistical value among 2003 and 2007 p ≤ 0.05. In contrast, there is an increase in the proportion of patients in the ICU receiving transfusions every year.
REFERENCES
Vincent JL, Piagnerelli M. Care Med 2006; 34, 5 (Suppl).
Taylor RW, O’Brien J, Trottier SJ et al. Red blood cell transfusions and nosocomial infections in critically ill patients. Crit Care Med 2006; 34: 2302-2308.
Taylor RW, Manganaro L, O’Brien J et al. Impact of allogenic packed red blood cell transfusion on nosocomial infections rates in the critically ill patient. Crit Care Med 2002; 30: 2249-2254.
Corwin HL, Gettinger A, Pearl RG et al. The CRIT Study: Anemia and blood transfusion in the critically ill-Current clinical practice in the United States. Crit Care Med 2004; 32: 39-52.
Henry ML, Garner WL, Fabri PJ. Iatrogenic anemia. Am J Surg 1986; 151: 362-363.
Smoller BR, Kruskall MS. Phlebotomy for diagnostic laboratory tests in adults. Pattern of use and effect on transfusion requirements. N Engl J Med 1986; 314: 1233-1235.
Corwin HL, Parsonnet KC, Gettinger A. RBC transfusion in the ICU. Is there a reason? Chest 1995; 108: 767-771.
Jelkmann WE, Fandrey J, Frede S et al. Inhibition of erythropoietin production by cytokines. Implications for the anemia envolved in inflammatory states. Ann N Y Acad Sci 1994; 718: 300-309.
Jelkmann W, Hellwig-Buergel T. Tumor necrosis factor p55 receptor (TNF-RI) mediates the in vitro inhibition of hepatic erythropoietin production. Exp Hematol 1999; 27: 224-228.
Zamai L, Secchiero P, Pierpaoli S et al. TNF related apoptosis-inducing ligand (TRAIL) as a negative regulator of normal human erythropoiesis. Blood 2000; 95: 3716-3724.
Krafte-Jacobs B, Levetown ML, Bray GL et al. Erythropoietin response to critical illness. Crit Care Med 1994; 22: 821-826.
Rogiers P, Zhang H, Leeman M et al. Erythropoietin response is blunted in critically ill patients. Intensive Care Med 1997; 23: 159-162.
DeAngelo AJ, Bell DG, Quinn MW et al. Erythropoietin response in critically ill mechanically ventilated patients: A prospective observational study. Crit Care 2005; 9: R172-R176.
Vincent JL, Sakr Y, Creteur J. Anemia in the intensive care unit. Can J Anaesth 2003; 50: S53-S59.
Lorente JA, Landin L, De Pablo R et al. Effects of blood transfusion on oxygen transport variables in severe sepsis. Crit Care Med 1993; 21: 1312-1318.
Fernandes CJ Jr, Akamine N, De Marco FV et al. Red blood cell transfusion does not increase oxygen consumption in critically ill. Crit Care 2001; 5: 362-367.
Walsh TS, McArdle F, McLellan SA et al. Does the storage time of transfused red blood cells influence regional or global indexes of tissue oxygenation in anemic critically ill patients? Crit Care Med 2004; 32: 364-371.
Hebert PC, Wells G, Blajchman MA et al. A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. N Engl J Med 1999; 340: 409-417.
Vincent JL, Baron JF, Reinhart K et al. Anemia and blood transfusion in critically ill patients. JAMA 2002; 288:1499-1507.
Dellinger RP, Carlet JM, Masur H et al. Surviving sepsis campaign guidelines for management of severe sepsis and septic shock. Crit Care Med 2004; 32: 858-873.
Weiskopf RB, Viele MK, Feiner J et al. Human cardiovascular and metabolic response to acute, severe isovolemic anemia. JAMA 1998; 279: 217-221.