scholarly journals Blood Transfusion in the Critically Ill Patient

2018 ◽  
Vol 6 (1) ◽  
pp. 40-46
Author(s):  
Jacob Pulinilkunnathil George ◽  
Sheila Nainan Myatra

Anaemia is commonly seen in the intensive care unit and is a cause of increased morbidity in the critically ill patients. Blood transfusion seems to be the physiological solution for anaemia, however it is not without complications and associated risks, questioning the benefit of packed red blood cell transfusion in this population. Physiological thresholds for transfusion seem to be an interesting concept, but currently lack evidence. The transfusion trigger across most populations favours a restrictive strategy for packed red blood cell transfusion, with the exception of some subgroups. Despite the presence of storage lesions in old blood, evidence suggest that the freshest available blood, does not fare better than the oldest available blood from the blood bank. This article is a review of the current evidence with blood transfusion practices in the critically ill patients.Bangladesh Crit Care J March 2018; 6(1): 40-46

2002 ◽  
Vol 30 (10) ◽  
pp. 2249-2254 ◽  
Author(s):  
Robert W. Taylor ◽  
Lisa Manganaro ◽  
Jacklyn O’Brien ◽  
Steven J. Trottier ◽  
Nadeem Parkar ◽  
...  

Blood Reviews ◽  
2003 ◽  
Vol 17 (4) ◽  
pp. 195-208 ◽  
Author(s):  
S.A. McLellan ◽  
D.B.L. McClelland ◽  
T.S. Walsh

2020 ◽  
Vol 7 (3) ◽  

More and more data is coming in recent times about hazards of blood transfusion. In a landmark TRICC1 trial Euvolemic patients in the intensive care unit (ICU) with Hb<9 g/dl were randomized to a restrictive transfusion strategy for transfusion of PRBCs (transfused if Hb<7 g/dl to maintain Hb between 7 and 9 g/dl) or a liberal strategy (transfused if Hb<10 g/dl to maintain Hb 10-12 g/dl). Mortality was similar in both groups, indicating that liberal transfusions were not beneficial. An Updated Report by the American Society of AnaesthesiologistsTask Force on Perioperative Blood Management tells us restrictive red blood cell transfusion strategy may be safely used to reduce transfusion administration. It further states that The determination of whether hemoglobin concentrations between 6 and 10 g/dl justify or require red blood cell transfusion should be based on potential or actual on going bleeding (rate and magnitude), intravascular volume status, signs of organ ischemia, and adequacy of cardiopulmonary reserve. Should we extrapolate these guidelines in Cardiac surgery? TRACS2 trial concluded that among patients undergoing cardiac surgery, the use of a restrictive perioperative transfusion strategy compared with a more liberal strategy resulted in noninferior rates of the combined outcome of 30-day all-cause mortality and severe morbidity.They advocated use of restrictive strategy, but 5 years later, the authors 3concluded that A restrictive transfusion threshold after cardiac surgery was not superior to a liberal threshold with respect to morbidity or health care costs. With this conflicting evidence, by which way anaesthesiologist to go?


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