Packed Red Blood Cell Transfusion and Decreased Mortality in Intracerebral Hemorrhage

Neurosurgery ◽  
2011 ◽  
Vol 68 (5) ◽  
pp. 1286-1292 ◽  
Author(s):  
Kevin N. Sheth ◽  
Aaron J. Gilson ◽  
Yuchiao Chang ◽  
Mona A. Kumar ◽  
Rosanna M. Rahman ◽  
...  
Keyword(s):  
Blood Cell ◽  
Intracerebral Hemorrhage ◽  
Red Blood Cell ◽  
Odds Ratio ◽  
Multivariable Analysis ◽  
Red Blood Cell Transfusion ◽  
Do Not Resuscitate ◽  
Tissue Oxygen ◽  
Brain Tissue Oxygen ◽  
Improved Outcome

Abstract BACKGROUND: Accumulating data suggest that anemia worsens outcomes in critically ill patients, including those with subarachnoid and intracerebral hemorrhage (ICH). Although packed red blood cell (PRBC) transfusion appears to increase brain tissue oxygen, it is unknown whether such transfusions, which are commonly administered in patients with intracranial hemorrhage, alter outcome. OBJECTIVE: Following up on our observation that anemia is associated with poor outcome in patients with ICH, we investigated whether PRBC transfusion was associated with any benefit. METHODS: Five hundred forty-six consecutive subjects were identified from an ongoing single-center, prospective cohort study of nontraumatic ICH over a 6-year period. Clinical and radiographic characteristics, laboratory values including admission and daily mean hemoglobin values, and all instances of PRBC transfusion were recorded. Aggressiveness of care was assessed by whether the patient had a “do not resuscitate” order activated during hospitalization. The primary endpoint was 30-day survival. RESULTS: Anemia was present in 144 of 546 patients (26%) on admission and developed subsequently in an additional 250, leaving just 152 of 546 patients (28%) who never developed anemia. PRBC transfusion was administered to 100 patients (18%) during their hospital stay, 98% of whom were anemic. In multivariable analysis, PRBC transfusion was associated with improved survival at 30 days (odds ratio: 2.76; 95% confidence interval: 1.45-5.26; P = .002). CONCLUSION: Anemia develops in the majority of patients with ICH at some point during their hospitalization. PRBC transfusion was associated with improved outcome in these patients.

Impact of minimal invasive extracorporeal circulation on the need of red blood cell transfusion

Perfusion ◽  
2019 ◽  
Vol 34 (7) ◽  
pp. 605-612 ◽  
Author(s):  
Sten Ellam ◽  
Otto Pitkänen ◽  
Pasi Lahtinen ◽  
Tadeusz Musialowicz ◽  
Mikko Hippeläinen ◽  
...  
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Extracorporeal Circulation ◽  
Odds Ratio ◽  
Artery Bypass ◽  
Postoperative Bleeding ◽  
Minimal Invasive ◽  
Red Blood Cell Transfusion ◽  
Red Blood Cell Transfusions ◽  
Hemoglobin Drop

Objective: Minimal invasive extracorporeal circulation may decrease the need of packed red blood cell transfusions and reduce hemodilution during cardiopulmonary bypass. However, more data are needed on the effects of minimal invasive extracorporeal circulation in more complex cardiac procedures. We compared minimal invasive extracorporeal circulation and conventional extracorporeal circulation methods of cardiopulmonary bypass. Methods: A total of 424 patients in the minimal invasive extracorporeal circulation group and 844 patients in the conventional extracorporeal circulation group undergoing coronary artery bypass grafting and more complex cardiac surgery were evaluated. Age, sex, type of surgery, and duration of perfusion were used as matching criteria. Hemoglobin <80 g/L was used as red blood cell transfusion trigger. The primary endpoint was the use of red blood cells during the day of operation and the five postoperative days. Secondary endpoints were hemodilution (hemoglobin drop after the onset of perfusion) and postoperative bleeding from the chest tubes during the first 12 hours after the operation. Results: Red blood cell transfusions were needed less often in the minimal invasive extracorporeal circulation group compared to the conventional extracorporeal circulation group (26.4% vs. 33.4%, p = 0.011, odds ratio 0.72, 95% confidence interval 0.55-0.93), especially in coronary artery bypass grafting subgroup (21.3% vs. 35.1%, p < 0.001, odds ratio 0.50, 95% confidence interval 0.35-0.73). Hemoglobin drop after onset of perfusion was also lower in the minimal invasive extracorporeal circulation group than in the conventional extracorporeal circulation group (24.2 ± 8.5% vs. 32.6 ± 12.6%, p < 0.001). Postoperative bleeding from the chest tube did not differ between the groups (p = 0.808). Conclusion: Minimal invasive extracorporeal circulation reduced the need of red blood cell transfusions and hemoglobin drop when compared to the conventional extracorporeal circulation group. This may have implications when choosing the perfusion method in cardiac surgery.

The Impact of Red Blood Cell Transfusion on Cerebral Tissue Oxygen Saturation in Severe Traumatic Brain Injury

2016 ◽  
Vol 26 (2) ◽  
pp. 247-255 ◽  
Author(s):  
Victoria A. McCredie ◽  
Simone Piva ◽  
Marlene Santos ◽  
Wei Xiong ◽  
Airton Leonardo de Oliveira Manoel ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Blood Cell ◽  
Severe Traumatic Brain Injury ◽  
Red Blood Cell ◽  
Red Blood Cell Transfusion ◽  
Tissue Oxygen Saturation ◽  
Tissue Oxygen ◽  
Cerebral Tissue ◽  
The Impact

Influence of enteral feeding and anemia on tissue oxygen extraction after red blood cell transfusion in preterm infants

Transfusion ◽  
2020 ◽  
Vol 60 (3) ◽  
pp. 466-472
Author(s):  
Gregory P. Goldstein ◽  
Anoop Rao ◽  
Albee Y. Ling ◽  
Victoria Y. Ding ◽  
Irene J. Chang ◽  
...  
Keyword(s):  
Blood Cell ◽  
Preterm Infants ◽  
Enteral Feeding ◽  
Red Blood Cell ◽  
Oxygen Extraction ◽  
Red Blood Cell Transfusion ◽  
Tissue Oxygen

scholarly journals Sexual Dimorphism in Hematocrit Response Following Red Blood Cell Transfusion of Critically Ill Surgical Patients

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Fredric M. Pieracci ◽  
Carlton C. Barnett ◽  
Nicole Townsend ◽  
Ernest E. Moore ◽  
Jeffery Johnson ◽  
...  
Keyword(s):  
Immune Response ◽  
Sexual Dimorphism ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Univariate Analysis ◽  
Multivariable Analysis ◽  
Red Blood Cell Transfusion ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
The Relationship

The change in hematocrit (ΔHct) following packed red blood cell (pRBCs) transfusion is a clinically relevant measurement of transfusion efficacy that is influenced by post-transfusion hemolysis. Sexual dimorphism has been observed in critical illness and may be related to gender-specific differences in immune response. We investigated the relationship between both donor and recipient gender and ΔHct in an analysis of all pRBCs transfusions in our surgical intensive care unit (2006–2009). The relationship between both donor and recipient gender and ΔHct (% points) was assessed using both univariate and multivariable analysis. A total of 575 units of pRBCs were given to 342 patients; 289 (49.9%) donors were male. By univariate analysis, ΔHct was significantly greater for female as compared to male recipients (3.81% versus 2.82%, resp., ). No association was observed between donor gender and ΔHct, which was 3.02% following receipt of female blood versus 3.23% following receipt of male blood (). By multivariable analysis, recipient gender remained associated significantly with ΔHct (). In conclusion, recipient gender is independently associated with ΔHct following pRBCs transfusion. This association does not appear related to either demographic or anthropomorphic factors, raising the possibility of gender-related differences in recipient immune response to transfusion.

A nationwide study for patterns of immune thrombocytopenia treatment in patients with chronic lymphocytic leukemia.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18193-e18193
Author(s):  
Suheil Albert Atallah-Yunes ◽  
Faris Haddadin ◽  
Anis Kadado ◽  
Jackson Clark ◽  
Audrey Anne Ready ◽  
...  
Keyword(s):  
Linear Regression ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Odds Ratio ◽  
Immune Thrombocytopenia ◽  
Platelet Transfusion ◽  
Multivariate Linear Regression ◽  
Lymphocytic Leukemia ◽  
Red Blood Cell Transfusion ◽  
Secondary Outcome

e18193 Background: Steroids and Intravenous immunoglobulin (IVIG) are considered as the first line of therapy in immune thrombocytopenia (ITP) when treatment is indicated. Approximately 5% of patients with untreated CLL and 25-30% of patients with previously treated CLL have thrombocytopenia. There is limited data about ITP treatment patterns and therapeutic responses in patients with CLL. Methods: This is a retrospective cohort study using the 2016 National Inpatient Sample of adults ( > 18 years) hospitalized for ITP as the admitting diagnosis and CLL as a secondary diagnosis based on ICD-10 codes. Primary outcomes were rate of administration of IVIG, splenectomy, platelet transfusion and packed red blood cell transfusion during same admission. Length of hospitalization was a secondary outcome. Multivariate linear regression was used to adjust for cofounders of age, gender, race and Charlson comorbidity Index. STATA 15 was used for analysis. Results: 14,490 patients were admitted for ITP (56% females, mean age 46), of which 255 had CLL (95 females, mean age was 72.4). On multivariate linear regression there was a significant increase in the use of IVIG among ITP patients with CLL (OR: 2.11; 95%-CI 1.05-4.23, P = 0.03). While there was no difference in terms of splenectomy rate ( OR: 0.35, 95% CI 0.05 to 2.52, p = 0.28 ) or rate of platelet transfusion (Odds ratio 1.15, 95% CI 0.63 to 2.08, p = 0.65) and packed red blood cell transfusion (Odds ratio 1.03, 95% CI 0.44 to 2.39, p = 0.94) between patients who have ITP with CLL and patients admitted with ITP without CLL. No statistical difference was found in hospitalization length. Conclusions: Patients hospitalized for ITP with CLL were more likely to require IVIGs. This could be explained by several theories including the need for a more rapid increase in platelet count as thrombocytopenia may be more severe due to bone marrow infiltration by CLL, immune dysfunction and/or treatment induced thrombocytopenia. Additionally, CLL patients can have hypogammaglobinemia making them more likely to get IVIG as a treatment of choice for ITP and as an immune replacement. Also ITP patients with CLL may have less response to steroids, as was noted in a previous study. Fear of atypical infections due to steroids in CLL patients may result in increased IVIG use. Further research of the microenvironment of ITP in CLL patients might explain the difference in treatment pattern and therapeutic response in this population.

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