Anemia Management Program Reduces Transfusion Volumes, Incidence of Ventilator-Associated Pneumonia, and Cost in Trauma Patients

Earley, Angela S.; Gracias, Vicente H.; Haut, Elliott R.; Sicoutris, Corinna; Wiebe, Douglas J.; Reilly, Patrick; Schwab, C. William

doi:10.1097/01.ta.0000225925.53583.27

Cited by 40 publications

(23 citation statements)

References 15 publications

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“…In another study about the effect of air pollution and anaemia on the rate of pneumonia hospitalization, anaemia in adjunctive with air pollution was found to increase the rate of hospitalization while air pollution in non-anaemic patients did not affect the rate of pneumonia hospitalizations [25]. Earley et al revealed that application of anaemia management programme in ICU reduced the complication rate of ventilator acquired pneumonia [26].…”

Section: Discussionmentioning

confidence: 97%

Usefulness of gender and abnormal blood count for predicting pneumonia outcome in children

Atwa

2015

Egyptian Journal of Chest Diseases and Tuberculosis

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Background: Pneumonia is still a leading cause of death among children in developing countries.The aim of the study is to identify some risk factors for poor pneumonia outcome. The studied factors were: male sex, thrombocytosis, thrombocytopaenia, leucocytosis, leucopaenia and anaemia.Patients and methods: A prospective cross sectional study included 242 children with community acquired pneumonia (CAP) who were attending a tertiary care hospital. Work for the study started at October 2012 and ended at August 2014. Medical history, physical examination, complete blood count (CBC) and C-reactive protein were done for all patients.Results: 27.3% of the patients developed pulmonary complications, 17.4% acquired sepsis while death occurred in 3.7% of cases. Multinomial logistic regression was used to detect the independent effect of each studied factor. Thrombocytosis, anaemia and age 62 years were associated with the development of pulmonary complications. Thrombocytopaenia and leucopaenia were associated with the fatal course of the disease. Male sex was a protective factor against pulmonary complications; however it was a risk factor for acquiring sepsis. Leucocytosis did not affect the prognosis of CAP.Conclusion: Sex of the patient and data from complete blood count are very useful for the prediction of pneumonia outcome. Anaemia, thrombocytosis, thrombocytopaenia, and leucopaenia are considered as predictors of bad prognosis. Females are more vulnerable to pulmonary complications while maleness is associated with sepsis and determination of these indicators highlights suspicion of pneumonia prognosis and allows application of early appropriate interventions.

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Section: Discussionmentioning

confidence: 97%

Usefulness of gender and abnormal blood count for predicting pneumonia outcome in children

Atwa

2015

Egyptian Journal of Chest Diseases and Tuberculosis

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“…McIntyre et al 68 found, in a randomized controlled trial (RCT), no changes in mortality, MOF or length of stay using a transfusion trigger of 7 mg/dL in trauma patients (n ϭ 203). Earley et al 69 saw in a retrospective investigation of trauma patients no increase in mortality or length of stay after reducing the transfusion trigger to 7 mg/dL, but a significant decrease of ventilator-associated pneumonia (n ϭ 514, p Ͻ 0.002) and a decrease in hospital cost of about $236 per patient. The available data supports a reduced transfusion trigger of 7 mg/dL in trauma patients.…”

Section: Therapeutic Consequencesmentioning

confidence: 96%

Erythropoiesis in Multiply Injured Patients

Robinson

Hostmann

Matenov

et al. 2006

The Journal of Trauma: Injury, Infection, and Critical Care

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Posttraumatic anemia in multiply injured patients is caused by hemorrhage, reduced red blood cell survival, and impaired erythropoiesis. Trauma-induced hyperinflammation causes impaired bone-marrow function by means of blunted erythropoietin (EPO) response, reduced iron availability, suppression and egress of erythroid progenitor cells. To treat posttraumatic anemia in severely injured patients, symptomatic therapy by blood transfusion is not sufficient. Furthermore, EPO, iron, and the use of red cell substitutes should be considered. The posttraumatic systemic inflammatory response syndrome (SIRS) induces posttraumatic anemia. Thus, a worsening of SIRS by a "second-hit" through blood transfusion ought to be avoided.

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“…RBCT also is an independent risk factor for impaired pulmonary function and prolonged ventilator support, acute lung injury, acute respiratory distress syndrome (ARDS) [84,85], systemic inflammatory response syndrome [83,86], renal dysfunction [87], multiple organ failure or dysfunction [34,88,89], transfusion reactions [39], and increased length of stay [33]. In SAH patients, RBCT has also been associated with medical complications and infection [29,57].…”

Section: Rbct In General Medical and Surgical Critical Carementioning

confidence: 98%

“…In general critical care patients, RBCT is associated with complications such as immunosuppression, transmission of infectious agents, postoperative infections, and pneumonia [77][78][79][80][81][82][83]. RBCT also is an independent risk factor for impaired pulmonary function and prolonged ventilator support, acute lung injury, acute respiratory distress syndrome (ARDS) [84,85], systemic inflammatory response syndrome [83,86], renal dysfunction [87], multiple organ failure or dysfunction [34,88,89], transfusion reactions [39], and increased length of stay [33].…”

Section: Rbct In General Medical and Surgical Critical Carementioning

confidence: 99%

Anemia and Transfusion After Subarachnoid Hemorrhage

Roux

2011

Neurocrit Care

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Delayed cerebral ischemia after subarachnoid hemorrhage (SAH) may be affected by a number of factors, including cerebral blood flow and oxygen delivery. Anemia affects about half of patients with SAH and is associated with worse outcome. Anemia also may contribute to the development of or exacerbate delayed cerebral ischemia. This review was designed to examine the prevalence and impact of anemia in patients with SAH and to evaluate the effects of transfusion. A literature search was made to identify original research on anemia and transfusion in SAH patients. A total of 27 articles were identified that addressed the effects of red blood cell transfusion (RBCT) on brain physiology, anemia in SAH, and clinical management with RBCT or erythropoietin. Most studies provided retrospectively analyzed data of very low-quality according to the GRADE criteria. While RBCT can have beneficial effects on brain physiology, RBCT may be associated with medical complications, infection, vasospasm, and poor outcome after SAH. The effects may vary with disease severity or the presence of vasospasm, but it remains unclear whether RBCTs are a marker of disease severity or a cause of worse outcome. Erythropoietin data are limited. The literature review further suggests that the results of the Transfusion Requirements in Critical Care Trial and subsequent observational studies on RBCT in general critical care do not apply to SAH patients and that randomized trials to address the role of RBCT in SAH are required.

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Anemia Management Program Reduces Transfusion Volumes, Incidence of Ventilator-Associated Pneumonia, and Cost in Trauma Patients

Cited by 40 publications

References 15 publications

Usefulness of gender and abnormal blood count for predicting pneumonia outcome in children

Usefulness of gender and abnormal blood count for predicting pneumonia outcome in children

Erythropoiesis in Multiply Injured Patients

Anemia and Transfusion After Subarachnoid Hemorrhage

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