Blood Tranfusion in Critically Ill Patients: State of the Art

Uludag University Medical Faculty Research Hospital Emergency Service an Epidemiological Investigation into Blood and Blood Product Transfusion

“…En doğru yaklaşım, düşük Hb riski ve transfüzyona ait riskler ile anemi derecesi ve kabul edilebilir Hb konsantrasyonu arasında iyi bir denge sağlanması olacaktır (50).…”

Fatores preditivos da transfusão de concentrado de hemácias em pacientes submetidos a cirurgias eletivas do aparelho digestivo: uma análise interinstitucional

“…There is clear evidence that RBCT can result in poor prognosis for critically ill patients and that the loss of effectiveness of red blood cells is related to storage time, nitric acid levels linked to free hemoglobin, leukocytes present in donor blood components, inflammatory response of the recipient and reduced cell plasticity that influences motility and gas exchange. (15) It is well known, for example, that surgical trauma and stress may have an important impact on the immunomodulation of patients with comorbidities such as tumors and that allogeneic transfusions may enhance the weaknesses of the immune response. (16) Similarly, a study involving 179 patients submitted to gastric surgery for tumors demonstrated, by univariate analysis, that a large volume of blood was transfused and that the transfusion practice was associated with a worse prognosis.…”

“…(11,(22)(23)(24) Hemoglobin levels were actually used as a trigger variable for the indication of transfusions for years, however the optimal hemoglobin levels vary considerably from one patient to another depending on multiple variables such as age, chronic diseases (especially coronary artery disease), current diagnosis, cause of anemia and anemia tolerance. (15,25,26) There are studies that clearly demonstrate the good tolerability that some patients with low hemoglobin levels have of anemia and the effectiveness of blood conservation strategies and autologous red blood cell production stimulating procedures, which maximize the final hematocrit without RBCT. (27,28) Another aspect to consider is that in gastrointestinal procedures, blood loss can be greatly minimized through minimally invasive surgical techniques, reduced surgical time and surgical planning with the conservation of the patient's blood by avoiding iatrogenic hemorrhages.…”

Transfusion Triggers in Cardiac Surgery

“…Özellikle miyokart başta olmak üzere pek çok vital organda akut anemiye bağlı gelişen iskemi, perioperatif morbidite ve mortaliteyi arttıracağından hızla tanınmalı ve tedavi edilmelidir. Bu hastalarda tedavideki ilk adımları intravasküler volümü yeterli hale getirmek, oksijenasyonu düzeltmek ve kan basıncını normal sınırlar içine çekmek için farmakolojik müdahaleler oluştururken, bazı hastalarda da transfüzyondan kaçınmak mümkün olamamaktadır (44) .…”