Transfusion profiles in intensive care units from a university hospital

Assunção, Murillo Santucci César de; Paula, Ilusca Cardoso de; Falcão, Luiz Fernando R.; Mazza, Bruno Franco; Barros, Marina Carvalho de Moraes; Jackiu, M; Fernandes, H.; Machado, FR

doi:10.1186/cc5572

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“…( 30 - 32 ) Although we did not measure the storage period of the RBCs transfused in this study, a previous report demonstrated that the median storage time of RBCs in blood banks was 14 (7-21) days, suggesting that at least half of this study’s patients received fresh blood. ( 33 ) Fourth, as already mentioned, the absence of cardiac output measurements and hemodynamic data after transfusion prevents analysis of the correlation between tissue oxygenation improvement and a possible increase in cardiac output secondary to increased preload after transfusion. Fifth, although we collected post-transfusion blood samples immediately after transfusion and there was no change in ventilator parameters or arterial oxygenation, we cannot eliminate the possibility that the observed changes in ScvO 2 and lactate could be influenced by modifications in oxygen saturation, changes in oxygen consumption ratio or as a consequence of aerobic glycolysis.…”

Section: Discussionmentioning

confidence: 99%

Blood transfusions in septic shock: is 7.0g/dL really the appropriate threshold?

Mazza¹,

Freitas²,

Barros³

et al. 2015

Revista Brasileira De Terapia Intensiva

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ObjectiveTo evaluate the immediate effects of red blood cell transfusion on central venous oxygen saturation and lactate levels in septic shock patients with different transfusion triggers.MethodsWe included patients with a diagnosis of septic shock within the last 48 hours and hemoglobin levels below 9.0g/dL Patients were randomized for immediate transfusion with hemoglobin concentrations maintained above 9.0g/dL (Group Hb9) or to withhold transfusion unless hemoglobin felt bellow 7.0g/dL (Group Hb7). Hemoglobin, lactate, central venous oxygen saturation levels were determined before and one hour after each transfusion.ResultsWe included 46 patients and 74 transfusions. Patients in Group Hb7 had a significant reduction in median lactate from 2.44 (2.00 - 3.22) mMol/L to 2.21 (1.80 - 2.79) mMol/L, p = 0.005, which was not observed in Group Hb9 [1.90 (1.80 - 2.65) mMol/L to 2.00 (1.70 - 2.41) mMol/L, p = 0.23]. Central venous oxygen saturation levels increased in Group Hb7 [68.0 (64.0 - 72.0)% to 72.0 (69.0 - 75.0)%, p < 0.0001] but not in Group Hb9 [72.0 (69.0 - 74.0)% to 72.0 (71.0 - 73.0)%, p = 0.98]. Patients with elevated lactate or central venous oxygen saturation < 70% at baseline had a significant increase in these variables, regardless of baseline hemoglobin levels. Patients with normal values did not show a decrease in either group.ConclusionRed blood cell transfusion increased central venous oxygen saturation and decreased lactate levels in patients with hypoperfusion regardless of their baseline hemoglobin levels. Transfusion did not appear to impair these variables in patients without hypoperfusion.ClinicalTrials.gov NCT01611753

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Section: Discussionmentioning

confidence: 99%