Purpose: To determine, retrospectively, the age of packed red blood cell (PRBC) units transfused to patients admitted to the ICU with the diagnosis of severe sepsis and to correlate this variable with outcome. Methods: All patients admitted to the ICU during 1992 with a diagnosis of severe sepsis were selected retrospectively. The criteria for the diagnosis of severe sepsis and septic shock were based on established guidelines. For each patient the total number of PRBC units transfused, the number of units transfused before, during and after the septic episode, and the age of each PRBC unit transfused were recorded.Results: Of the 31 patients admitted to the ICU with severe sepsis, 19 died and 12 survived. No statistical differences between survivors and nonsurvivors were found with respect to age, sex, number of days in ICU, duration of sepsis, incidence of septic shock, admission Apache II score or total number of PRBC units transfused. During sepsis the median age of PRBC units transfused to survivors was 17 days (range 5-35) vs 25 days (range 9-36) for nonsurvivors (P < 0.000 I). A negative correlation (r = -0.73) was found between the proportion of PRBC units of a given age transfused to survivors and increasing age of PRBC.Conclusion: This is the first study to report a correlation of mortality with the age of PRBC transfused. The cause of this association is unclear. If this association is confirmed by a prospective randomised trial it would have major implications for the use of PRBC in severe sepsis.Objectif : DEterminer rEtrospectivement I'~ge des concentrEs Erythrocytaires (CE) transfuses ~ des patients admis ~ I'unitE des soins intensifs (USI) avec un diagnostic de sepsis grave et vEriJier si cette variable a une correlation avec le devenir des patients.M&hodes : Tousles patients admis ~ I'USI en 1992 avec un diagnostic de sepsis grave ont fait I'objet de cette recherche retrospective. Les signes et sympt6mes usuels ont servi ~ Etablir les critEres de sepsis grave et de choc septique. Pour chacun des patients la quantitE totale des CE transfuses, le nombre de CE transfuses avant, pendant et aprEs I'Episode septique et I'~ge de chaque CE transfuse ont EtE enregistrEs. R~ultats : Parmi les 31 patients admis ~ I'USI pour sepsis grave, 19 sont dEcEdEs et 12 ont surv&u. II n'y avait pas de difference statistique entre survivants et non survivants en rapport ~ I'~ge, le sexe, la durEe du sEjour I'USI, la durEe du sepsis, I'incidence du choc septique, le score APACHE II ~ I'admission et le nombre de CE transfuses. Au cours du sepsis, I'~ge median des CE transfuses Etait de 17 jours (Ecart 5--35) vs 25 jours (&art 9-39) pour les non survivants (P < 0,0001). On a trouvE une correlation negative (r = -0,73) entre la proportion de CE d'un ~ge dEterminE transfuse aux survivants et I'accroissement de I'~ge des CE. Conclusion : II s'agit ici de la premiere Etude concluant ,~ une correlation avec I'~-ge des CE transfuses. La raison de cette association n'est pas claire. Si une Etude alEatoire prospective parvient ~...
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