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Haemoglobin level in Scottish intensive care patients--a national one day survey
M A Garrioch1, G C Fletcher, A P Holmes
1Department of Anaesthesia, South Glasgow University Hospitals NHS Trust, University of Glasgow, Glasgow. magnus.garrioch@virgin.net
Insights
Scottish Intensive Care Units (ICUs) aim for hemoglobin levels between 70-100 g/l. However, clinician blood ordering habits show inconsistency, necessitating further research into optimal transfusion triggers.
Area of Science:
- Critical Care Medicine
- Hematology
- Clinical Survey Research
Background:
- Understanding hemoglobin (Hb) levels and transfusion practices in Intensive Care Units (ICUs) is crucial for patient management.
- Variability in clinical decision-making regarding blood transfusions can impact patient outcomes and resource utilization.
Purpose of the Study:
- To assess current hemoglobin levels and blood ordering practices among clinicians in Scottish ICUs on a typical day.
- To identify the triggers and patterns of blood transfusion in critically ill patients.
Main Methods:
- A questionnaire survey was distributed to all adult ICUs in Scotland.
- Data were collected from patients admitted to responding ICUs on a specific date (February 29, 2000).
Main Results:
- Nineteen of 26 Scottish ICUs responded, providing data on 78 patients; 8 (10%) received blood transfusions.
- The mean initial hemoglobin level was 102 g/l. The modal transfusion trigger hemoglobin was 80 g/l (38%) and 100 g/l (24%).
- No ICU allowed hemoglobin below 70 g/l, and no transfusions occurred above 100 g/l. Ischemic heart disease was a significant trigger for transfusion.
Conclusions:
- Scottish ICUs generally maintain hemoglobin levels between 70-100 g/l.
- Clinician practices in ordering blood transfusions exhibit inconsistency.
- Further investigation is needed to establish optimal hemoglobin thresholds for transfusion in the ICU population.
Unlabelled:
Objectives were to determine haemoglobin (Hb) levels present in patients and blood ordering habits of clinicians within Scottish Intensive Care Units (ICUs) on one typical day. A questionnaire survey (February 29 2000) was sent to all adult Scottish ICUs. All patients present in the responding adult ICUs in Scotland on the above date were included.
Measurements And Main Results:
Nineteen (73%) of the 26 Scottish Adult Intensive Care Units (ICUs) responded to the questionnaire. Data were received from 78 patients, 8 (10%) received blood. Mean initial Hb was 102 g/l (range 63-138). Modal transfusion trigger haemoglobin was 80 g/l in 38% of subjects at first trigger, 100 g/l in 24% of cases. No intensive care unit allowed haemoglobin to fall below 70 g/l and no patients were transfused when measured Hb was greater than 100 g/l. The presence of ischaemic heart disease was the second most important trigger to transfuse after haemoglobin level. Modal transfusion was 2 units (n = 7). Only one patient received a single unit transfusion.
Conclusions:
Scottish ICUs maintain Hb between 70 and 100 g/l but clinicians are currently not consistent when ordering blood. More investigation is required to determine the optimal haemoglobin in our ICU population.
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