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Related Experiment Videos

Transfusion practice in the critically ill.

Howard L Corwin1, Stephen D Surgenor, Andrew Gettinger

  • 1Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA. howard.l.corwin@hitchcock.org

Critical Care Medicine
|January 16, 2004
PubMed
Summary
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Critically ill patients often develop anemia, leading to frequent blood transfusions. A conservative approach, reducing transfusion triggers and blood loss, is recommended for better patient outcomes.

Area of Science:

  • Critical Care Medicine
  • Hematology

Background:

  • Anemia is prevalent in critically ill patients, presenting as a distinct clinical entity.
  • Characterized by impaired erythropoietin production and altered iron metabolism, similar to anemia of chronic disease.

Purpose of the Study:

  • To evaluate the necessity and efficacy of blood transfusions in critically ill patients.
  • To advocate for revised transfusion strategies in intensive care settings.

Main Methods:

  • Review of transfusion practices and patient outcomes in intensive care units.
  • Analysis of evidence supporting routine versus restrictive red blood cell transfusion.

Main Results:

  • 40-50% of ICU patients receive red blood cell transfusions, averaging nearly five units per stay.

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  • Limited evidence supports routine transfusion of stored allogeneic red blood cells.
  • Critically ill patients can often tolerate hemoglobin levels as low as 7 mg/dL.

    • Conclusions:

    • A conservative approach to red blood cell transfusion is warranted.
    • Strategies should focus on minimizing blood loss through phlebotomy.
    • Lowering the transfusion threshold in critically ill patients is advised.