[Transfusion practices in brazilian Intensive Care Units (pelo FUNDO-AMIB)]

Area of Science:

• Critical Care Medicine
• Hematology
• Intensive Care Unit (ICU) Research

Context:

• Anemia of critical illness is complex, influenced by blood loss, phlebotomy, and impaired red blood cell (RBC) production.
• Debate exists regarding optimal hemoglobin concentration thresholds for RBC transfusions in critically ill patients.

Purpose:

• To investigate red blood cell (RBC) transfusion practices and associated outcomes in Brazilian Intensive Care Units (ICUs).

Summary:

• A prospective study in 19 Brazilian ICUs over two weeks included 231 patients with ICU stays >48 hours.
• 33% of patients had hemoglobin <10 g/dL on admission. 36.5% received 348 RBC units, with a mean pretransfusion hemoglobin of 7.7 ± 1.1 g/dL.
• Transfused patients had higher SOFA scores, longer mechanical ventilation, and vasoactive drug use, but similar APACHE II scores and non-significantly higher mortality compared to non-transfused patients.

Impact:

• Findings suggest a trend towards restrictive transfusion practices in Brazilian ICUs, utilizing lower hemoglobin triggers.
• This approach may be associated with comparable outcomes despite lower pretransfusion hemoglobin levels.
• Highlights the need for continued evaluation of transfusion strategies in critical care settings.