scholarly journals Association of red blood cell and platelet transfusions with persistent inflammation, immunosuppression, and catabolism syndrome in critically ill patients

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Ginga Suzuki ◽  
Ryo Ichibayashi ◽  
Yuka Masuyama ◽  
Saki Yamamoto ◽  
Hibiki Serizawa ◽  
...  

AbstractThe objective of this single-center retrospective cohort study was to investigate the relationship between blood transfusion and persistent inflammation, immunosuppression, and catabolism syndrome (PIICS). The study was conducted at the Critical Care Center at Toho University Omori Medical Center, Japan. We included 391 patients in the PIICS group (hospitalization for > 15 days, C-reactive protein > 3.0 mg/dL or albumin < 3.0 mg/dL or lymph < 800/μL on day 14) and 762 patients in the non-PIICS group (hospitalization for > 15 days and not meeting the PIICS criteria). We performed univariate and multivariate logistic regression analyses using PIICS as the objective variable and red blood cell (RBC) or fresh frozen plasma or platelet (PLT) transfusion and other confounding factors as explanatory variables. In addition, we conducted a sensitivity analysis using propensity score matching analysis. The multivariate and propensity score analyses showed that RBC and PLT transfusions were significantly associated with PIICS. This is the first study to report an association between RBC and PLT transfusions and PIICS. Our findings have contributed to better understanding the risk factors of PIICS and suggest that physicians should consider the risk of PIICS occurrence when administering blood transfusions in intensive care unit (ICU) patients.

2021 ◽  
Author(s):  
Ginga Suzuki ◽  
Ryo Ichibayashi ◽  
Yuka Masuyama ◽  
Saki Yamamoto ◽  
Hibiki Serizawa ◽  
...  

Abstract The objective of this single-center retrospective cohort study was to investigate the relationship between blood transfusion and persistent inflammation, immunosuppression, and catabolism syndrome (PIICS). The study was conducted at the Critical Care Center at Toho University Omori Medical Center, Japan. We included 391 patients in the PIICS group (hospitalization for > 15 days, C-reactive protein > 3.0 mg/dL or albumin < 3.0 mg/dL or lymph < 800/µL on day 14) and 762 patients in the non-PIICS group (hospitalization for > 15 days and not meeting the PIICS criteria). We performed univariate and multivariate logistic regression analyses using PIICS as the objective variable and red blood cell (RBC) or fresh frozen plasma or platelet (PLT) transfusion and other confounding factors as explanatory variables. In addition, we conducted sensitivity analysis using propensity score matching analysis. The multivariate and propensity score analyses showed that RBC and PLT transfusions were significantly associated with PIICS. This is the first study to report an association between RBC and PLT transfusions and PIICS. Our findings have contributed to better understanding the risk factors of PIICS and suggest that physicians should consider the risk of PIICS occurrence when administering blood transfusions in intensive care unit (ICU) patients.


Neurosurgery ◽  
2017 ◽  
Vol 82 (6) ◽  
pp. 877-886 ◽  
Author(s):  
Prateek Agarwal ◽  
Kalil G Abdullah ◽  
Ashwin G Ramayya ◽  
Nikhil R Nayak ◽  
Timothy H Lucas

AbstractBACKGROUNDReversal of therapeutic anticoagulation prior to emergency neurosurgical procedures is required in the setting of intracranial hemorrhage. Multifactor prothrombin complex concentrate (PCC) promises rapid efficacy but may increase the probability of thrombotic complications compared to fresh frozen plasma (FFP).OBJECTIVETo compare the rate of thrombotic complications in patients treated with PCC or FFP to reverse therapeutic anticoagulation prior to emergency neurosurgical procedures in the setting of intracranial hemorrhage at a level I trauma center.METHODSSixty-three consecutive patients on warfarin therapy presenting with intracranial hemorrhage who received anticoagulation reversal prior to emergency neurosurgical procedures were retrospectively identified between 2007 and 2016. They were divided into 2 cohorts based on reversal agent, either PCC (n = 28) or FFP (n = 35). The thrombotic complications rates within 72 h of reversal were compared using the χ2 test. A multivariate propensity score matching analysis was used to limit the threat to interval validity from selection bias arising from differences in demographics, laboratory values, history, and clinical status.RESULTSThrombotic complications were uncommon in this neurosurgical population, occurring in 1.59% (1/63) of treated patients. There was no significant difference in the thrombotic complication rate between groups, 3.57% (1/28; PCC group) vs 0% (0/35; FFP group). Propensity score matching analysis validated this finding after controlling for any selection bias.CONCLUSIONIn this limited sample, thrombotic complication rates were similar between use of PCC and FFP for anticoagulation reversal in the management of intracranial hemorrhage prior to emergency neurosurgical procedures.


Transfusion ◽  
2015 ◽  
Vol 56 (4) ◽  
pp. 816-826 ◽  
Author(s):  
Kavitha Subramaniam ◽  
Katrina Spilsbury ◽  
Oyekoya T. Ayonrinde ◽  
Faye Latchmiah ◽  
Syed A. Mukhtar ◽  
...  

2009 ◽  
Vol 9 (10) ◽  
pp. 107S-108S
Author(s):  
Albert Pull Ter Gunne ◽  
Richard Skolasky ◽  
Hillary Ross ◽  
David Cohen

2021 ◽  
Vol 49 (5) ◽  
pp. 365-372
Author(s):  
Cyril Pernod ◽  
◽  
Laurie Fraticelli ◽  
Guillaume Marcotte ◽  
Bernard Floccard ◽  
...  

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4358-4358
Author(s):  
Marek Seweryn ◽  
Dariusz Kata ◽  
Slawomira Kyrcz-Krzemien

Abstract Abstract 4358 Background Addition of purine analogues to standard induction therapy of acute myeloid leukemia (AML) had previously been demonstrated to increase complete remission rate and does not aggravate infectious complications. The aim of this study was to analyze whether the use of cladribine or fludarabine during induction and consolidation treatment increase the need for more frequent transfusions of red blood cell concentrates, platelet concentrates and fresh frozen plasma. Material and methods 118 AML patients, included in two consecutive randomized trials between 1999–2006 in a single centre were analyzed. Induction therapy consisted of daunorubicin + cytarabine (DA-7, n=53) alone or in combination with cladribine or fludarabine (DAC-7 + DAF-7, n=65). Consolidation included one course of high-dose AraC + mitoxantrone and one course of high-dose AraC +/− purine analogues. A median age was 45(17-58) years and 48(20-60) years for patients treated with and without purine analogues, respectively. Results During induction treatment 7 (1-19) units of red blood cell concentrates (median and range) was transfused in the group with purine analogues compared to 6 (1-23) in the group without purine analogues, p=0,24. Number of transfused platelet concentrates bags was 6 (1-30) in the group of purine analogues and 7 (0-19) in the group without purine analogues, p = 0.49. In the group with purine analogues 0 (0-31) units of fresh frozen plasma was transfused compared to 0 (0-26) in the group without purine analogues, p = 0.91. During HAM consolidation therapy 3 (0-11) units of red blood cell concentrates was transfused in the group with purine analogues compared to 2 (0-9) in the group without purine analogues, p = 0.15. Number of transfused platelet concentrates bags in the group with purine analogues was 2 (0-8) vs. 2 (0-12) in the group without purine analogues, p = 0.25. In the course of HAM consolidation treatment - 0 (0-56) units of fresh frozen plasma was transfused in the group with purine analogues compared to 0 (0-0) in the group without purine analogues, p = 0.027. During HD Ara-C consolidation therapy 3 (0-7) units of red blood cell concentrates was transfused in the group with purine analogues compared to 2 (0-5) in the group without purine analogues, p = 0.03. Number of transfused platelet concentrates bags in the group treated with purine analogues was 3 (1-12) vs. 3 (1-6) in the group without purine analogues, p = 0.61. In the course of HD Ara-C consolidation treatment 0 (0-9) units of fresh frozen plasma was transfused in the group with purine analogues compared to 0 (0-11) in the group without purine analogues, p=0,34. Conclusions The vast majority of the obtained results did not reveal any significant differences between the group of AML patients treated with or without purine analogues. During HAM consolidation treatment statistical significance for more fresh frozen plasma units transfused was shown in the patients treated with purine analogues, although the median value was the same in both groups (0). This situation was random and independent of prior use of purine analogues in the induction therapy, because in one of the woman-patient gynecological complications and DIC occurred (bleeding from uterine fibroids). This situation required intensive supportive therapy including fresh frozen plasma transfusions. In one case 56 units of fresh frozen plasma was transfused and in second arm of the study was not applied a plasma transfusions in any patient. Also during second (HD Ara-C) consolidation treatment number of transfused units of RBC's concentrates was significant higher in the group of patients treated with purine analogues, although the median values were similar (3 vs 2). These differences may arise from the fact that in some patients - especially in group of patients treated with purine analogues who obtained the better results of therapy – second HD Ara-C treatment was also more often followed by mobilization and collection of stem cells from peripheral blood for transplantation. In the procedure of stem cells collection a higher hematocrit value is recommended – so frequent decision for RBC's transfusions was made in this group of patients. We conclude that the use of purine analogues in the treatment of AML patients does not increase the need for more frequent transfusions of red blood cell concentrates, platelet concentrates and fresh frozen plasma. Disclosures: No relevant conflicts of interest to declare.


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