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>Journals >Medicina Crítica >Year 2011, Issue 3


Flores MP, Gartz TG, Treviño FRJ, Ramírez RA
Incidencia de complicaciones en pacientes críticos relacionadas a transfusiones
Rev Asoc Mex Med Crit y Ter Int 2011; 25 (3)

Language: Español
References: 26
Page: 160-168
PDF: 373.44 Kb.


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ABSTRACT

Despite the high incidence of anemia in critical ill patients, there is a lack of criteria for appropriate use of transfusions. This work provides an overview of blood transfusion practices and describes its complications.
Objective: To recognize the characteristics of blood transfusion practices and the incidence of complications.
Study design and methods: Prevalence study, non-probabilistic sampling with a total of 90 intensive care unit patients during the period (2004-2009).
Results: Mean hemoglobin at admission 10.8 g/dL, with mean pretransfusion hemoglobin of 9.6 g/dL, with 32.2% transfusions without adherence to recommendations. There was no impact in the use of restrictive blood transfusion with severe complications and mortality (RR 1.15 IC95% 0.68-1.85, RR 0.61 IC 95% 0.26-1.30), but with the use of › 5 blood cells concentration led to major complications and mortality (RR 2.06 IC 95% 1.27-3.25) (RR 2.96 IC 95% 1.53-5.81), as with the use of › 7 platelet concentrates resulting major complications and mortality (RR 2.305 IC95% 1.41-3.63) (RR 5.23 IC95% 2.5-11.49).
Conclusions: The observation with the worst results concurred with the previous statement, given the high proportion of liberal transfusion, justifies establishing restrictive policies in our hospital.


Key words: Critical care, restrictive transfusion vs liberal, severe complications, mortality.


REFERENCIAS

  1. PubMed-Medline. http://www.ncbi.nlm.nih.gov/entrez/

  2. Miller. Miller’s Anesthesia, 6th ed 2005. Cap 47 Transfusion Therapy Churchill Livingstone, An Imprint of Elsevier.

  3. Raghavan M, Marik PE. Anemia, allogenic blood transfusion, and immunomodulation in the critically ill www.chestjournals. org (2005)127:295-307.

  4. Shander A. Anemia in the critically ill. Crit Care Clin 2004;20:159-178.

  5. Hébert PC, Wells G, Blajchman MA, Marshall J, Martin C, Pagliarello G, Tweeddale M, Schweitzer I, Yetisir E. [A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. Transfusion Requirements in Critical Care Investigators, Canadian Critical Care Trials Group]. N Engl J Med 1999;341(2):123-4.

  6. Vincent JL, Baron JF, Reinhart K, Gattinoni L, Thijs L, Webb A, Meier-Hellmann A, Nollet G, Peres-Bota D; ABC (Anemia and Blood Transfusion in Critical Care) Investigators. Anemia and blood transfusion in critically ill patients. JAMA 2002;288(12):1499-507.

  7. Hill SR, Carless PA, Henry DA, Carson JL, Herbert PC, McClelland DB, Henderson KM. Transfusion thresholds and other strategies for guiding allogenic red blood cell transfusion. Cochrane Database Syst Rev 2002.

  8. Corwin HL, Surgenor SD, Gettinger A. Transfusion practice in the critically ill. Crit Care Med 2003;31(12 Suppl):S668-71.

  9. Corwin HL, Gettinger A, Pearl RG, Fink MP, Levy MM, Abraham E, MacIntyre NR, Shabot MM, Duh MS, Shapiro MJ. (The CRIT Study: Anemia and blood transfusion in the critically ill--current clinical practice in the United States). Crit Care Med 2004;32(1):39-52.

  10. Spahn DR, Marcucci C. Blood management in intensive care medicine: CRIT and ABC what can we learn? Crit Care 2004;8(2):89-90.Epub 2004 Feb 27.

  11. Dunne JR, Malone DL, Tracy JK, Napolitano LM. Allogenic blood transfusion in the first 24 hours after trauma is associated with increased systemic inflammatory response syndrome (SIRS) and death. Surg Infect (Larchmt) 2004;5(4):395-404.

  12. Vincent JL, Piagnerelli M. Transfusion in the intensive care unit. Crit Care Med 2006;34(5 Suppl):S96-101.

  13. Earley AS, Gracias VH, Haut E, Sicoutris CP, Wiebe DJ, Reilly PM, Schwab CW. Anemia management program reduces transfusion volumes, incidence of ventilator-associated pneumonia, and cost in trauma patients. J Trauma 2006;61(1):1-5;discussion 5-7.

  14. Khan H, Belsher J, Yilmaz M, Afessa B, Winters JL, Moore SB, Hubmayr RD, Gajic O. Fresh-frozen plasma and platelet transfusions are associated with development of acute lunh injury in critically ill medical patients. Chest 2007;131(5):1308-14.

  15. Tinmouth AT, McIntyre LA, Fowler RA. Blood conservation strategies to reduce the need for red blood cell transfusion in critically ill patients. CMAJ 2008;178(1):49-57.

  16. Zilberberg MD, Stern LS, Wiederkher DP, Doyle JJ, Shorr AF. Anemia, transfusions and hospital outcomes among critically ill patients on prolonged acute mechanical ventilation: a retrospective cohort study. Crit Care 2008;12(2):R60.Epub 2008 Apr 28.

  17. Marik PE, Corwin HL. Efficacy of red blood cell transfusion in the critcally ill: a systematic review of the literature. Crit Care Med 2008;36(9):2707-8.

  18. Nichol AD. Restrictive red blood cell transfusion strategies in critical care: does one size really fit all? Crit Care Resusc 2008;10(4):323-7.

  19. Brandt MM, Rubinfeld I, Jordan J, Trivedi D, Horst HM. Transfusion insurgency: practice change through education and evidence-based recommendations. Am J Surg 2009;197(3):279-83.

  20. Raghavan M, Marik PE. Anemia, allogenic blood transfusion, and immunomodulation in the critically ill. Chest 2005;127;295-307.

  21. Maclntyre NR, Epstein SK, Carson S, Scheinhorn D, Christopher K, Muldoon S. Management of patients requiring prolongated mechanical ventilation. Chest 2005;128;3937-3954.

  22. Beutler E, Lichtman MA, Coller BS, Kipps TJ, Seligsohn U. Williams Hematología. Marbán (Ed.) Conservación y uso clínico de los hematíes y del sangre total. Madrid, España. 2005:1879-1892.

  23. Agrawal M, Swartz R. Acute Renal Failure 2000 Apr 1. AFP. Vol.61/No.7.

  24. Am J Respir Crit Care Med. Guidelines for the management of adults with hospital acquired, ventilator-associated, and healthcare-associated pneumonia. 2005;171:388-416.

  25. Ware LB, Matthay MA,. The acute respiratory distress syndrome. N Engl J Med 2000;342:1334.

  26. Marin HK, Eisenberg PR. A rapid qualitative assay to detect circulating endotoxin can predict the development of multiorgan dysfunction. Chest 1997;112:173-180.






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