Red Blood Cell Transfusion in Sepsis: A Review

Sadaka, Farid

doi:10.4172/2155-9864.s4-001

Cited by 10 publications

(9 citation statements)

References 100 publications

(56 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…pRBC transfusion can cause complications ranging from allergic reactions, transfusion-related infections, and febrile reactions, to more severe complications like acute lung injury, circulatory overload, immunomodulation, or hemolysis [ 83 ]. In an active surveillance in California that involved 463,207 units of blood and blood components, the incidence of transfusion-related acute lung injury in 2009 was only 0.81 per 10,000 units transfused [ 84 ].…”

Section: Complications Of Prbc Transfusion During Sepsismentioning

confidence: 99%

Transfusion of Red Blood Cells to Patients with Sepsis

Chan

Han

et al. 2017

IJMS

View full text Add to dashboard Cite

Sepsis is one of the major causes of death worldwide, and is the host response to infection which renders our organs malfunctioning. Insufficient tissue perfusion and oxygen delivery have been implicated in the pathogenesis of sepsis-related organ dysfunction, making transfusion of packed red blood cells (pRBCs) a reasonable treatment modality. However, clinical trials have generated controversial results. Even the notion that transfused pRBCs increase the oxygen-carrying capacity of blood has been challenged. Meanwhile, during sepsis, the ability of our tissues to utilize oxygen may also be reduced, and the increased blood concentrations of lactate may be the results of strong inflammation and excessive catecholamine release, rather than impaired cell respiration. Leukodepleted pRBCs more consistently demonstrated improvement in microcirculation, and the increase in blood viscosity brought about by pRBC transfusion helps maintain functional capillary density. A restrictive strategy of pRBC transfusion is recommended in treating septic patients.

show abstract

Section: Complications Of Prbc Transfusion During Sepsismentioning

confidence: 99%

Transfusion of Red Blood Cells to Patients with Sepsis

Chan

Han

et al. 2017

IJMS

View full text Add to dashboard Cite

show abstract

“…14 Anemia and hypoalbuminemia are associated with sepsis. [15][16][17] Sepsis alters RBC morphology and membrane composition and both contribute to the development of anemia in septic patients. 15,16 Severe anemia often occurs in sepsis.…”

Section: Discussionmentioning

confidence: 99%

“…[15][16][17] Sepsis alters RBC morphology and membrane composition and both contribute to the development of anemia in septic patients. 15,16 Severe anemia often occurs in sepsis. 14 An association between a low serum albumin and infection has been found in intensive care unit patients and serum albumin has been noted to be low in sepsis (below 2.0 g/100 ml).…”

Section: Discussionmentioning

confidence: 99%

An unusual case of peritonitis following a caesarean delivery

Gado

Badawi

Karim

2018

Alexandria Journal of Medicine

View full text Add to dashboard Cite

Postoperative fluid accumulation is a very rare complication of caesarean delivery. We present an unusual case of peritonitis of unknown origin following a caesarean delivery. Emergency surgery was performed. On exploration there was a large amount of clear fluid which was removed. No signs of iatrogenic injury or any abnormality was detected. Fluid cultures of fluid drained from the abdomen did not grow any organisms. The working diagnosis was reactive peritonitis. Post exploratory laparotomy sepsis developed which was managed conservatively. The patient was discharged after full recovery.

show abstract

“…This line of reasoning led to the common practice of maintaining this “10/30 rule” as the transfusion trigger. Subsequently, several problems were documented with RBC transfusions, such as infection, pulmonary complications such as TRALI and transfusion-associated circulatory overload (TACO), transfusion-related immunomodulation (TRIM) and multiorgan failure, and increased mortality [ 20 ]. This lead to the need for evaluation of restrictive transfusion strategies.…”

Section: Discussionmentioning

confidence: 99%

Transfusion of Red Blood Cells Is Associated With Improved Central Venous Oxygen Saturation But Not Mortality in Septic Shock Patients

Sadaka¹,

Trottier²,

Tannehill³

et al. 2014

J Clin Med Res

View full text Add to dashboard Cite

BackgroundAlthough the optimum hemoglobin (H) concentration for patients with septic shock (SS) has not been specifically investigated, current guidelines suggest that H of 7 - 9 g/dL, compared with 10 - 12 g/dL, was not associated with increased mortality in critically ill adults. This contrasts with early goal-directed resuscitation protocols that use a target hematocrit of 30% in patients with low central venous oxygen saturation (ScvO2) during the first 6 hours of resuscitation of SS.MethodsData elements were prospectively collected on all patients with SS patients (lactic acid (LA) > 4 mmol/L, or hypotension). Out of a total of 396 SS patients, 46 patients received red blood cell (RBC) transfusion for ScvO2 < 70% (RBC group). We then matched 71 SS patients that did not receive RBC transfusion (NRBC group) on the following goals (G): LA obtained within 6 hours (G1), antibiotics given within 3 hours (G2), 20 mL/kg fluid bolus followed by vasopressors (VP) if needed to keep mean arterial pressure > 65 mm Hg (G3), central venous pressure > 8 mm Hg within 6 hours (G4) and ScvO2 > 70% within 6 hours (G5).ResultsIn the RBC group, after one unit of RBC transfusion, ScvO2 improved from average of 63% (± 12%) to 68% (± 10%) (P = 0.02). Sixteen patients required another unit of RBC, and this resulted in increase of ScvO2 to 78% (± 11%) (P < 0.01). The RBC and NRBC groups were matched on sequential organ failure assessment (SOFA) scores and all five goals. There was no difference in mortality between the two groups: 41% vs. 39.4% (OR: 0.8, 95% CI: 0.4 - 1.7, P = 0.6).ConclusionsIn our study, transfusion of RBC was not associated with decreased mortality in SS patients.

show abstract

Red Blood Cell Transfusion in Sepsis: A Review

Cited by 10 publications

References 100 publications

Transfusion of Red Blood Cells to Patients with Sepsis

Transfusion of Red Blood Cells to Patients with Sepsis

An unusual case of peritonitis following a caesarean delivery

Transfusion of Red Blood Cells Is Associated With Improved Central Venous Oxygen Saturation But Not Mortality in Septic Shock Patients

Contact Info

Product

Resources

About