TITLE

Blood conservation strategies to reduce the need for red blood cell transfusion in critically ill patients

AUTHOR(S)
Tinmouth, Alan T.; McIntyre, Lauralynn A.; Fowler, Robert A.
PUB. DATE
January 2008
SOURCE
CMAJ: Canadian Medical Association Journal;1/1/2008, Vol. 178 Issue 1, p49
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Anemia commonly affects critically ill patients. The causes are multifactorial and include acute blood loss, blood loss from diagnostic testing and blunted red blood cell production. Blood transfusions are frequently given to patients in intensive care units to treat low hemoglobin levels due to either acute blood loss or subacute anemia associated with critical illness. Although blood transfusion is a life-saving therapy, evidence suggests that it may be associated with an increased risk of morbidity and mortality. A number of blood conservation strategies exist that may mitigate anemia in hospital patients and limit the need for transfusion. These strategies include the use of hemostatic agents, hemoglobin substitutes and blood salvage techniques, the reduction of blood loss associated with diagnostic testing, the use of erythropoietin and the use of restrictive blood transfusion triggers. Strategies to reduce blood loss associated with diagnostic testing and the use of hemostatic agents and erythropoietin result in higher hemoglobin levels, but they have not been shown to reduce the need for blood transfusions or to improve clinical outcomes. Lowering the hemoglobin threshold at which blood is transfused will reduce the need for transfusions and is not associated with increased morbidity or mortality among most critically ill patients without active cardiac disease. Further research is needed to determine the potential roles for other blood conservation strategies.
ACCESSION #
27995967

 

Related Articles

  • Effect of a blood conservation device in patients with preserved admission haemoglobin in the intensive care unit. MUKHOPADHYAY, A.; SEE, K. C.; CHAN, Y. H.; YIP, H. S.; PHUA, J. // Anaesthesia & Intensive Care;May2011, Vol. 39 Issue 3, p426 

    The article discusses the results of a study which investigates the benefits of using a closed system blood conservation device in patients with preserved level of hemoglobin on admission to the intensive care unit (ICU). According to the authors, the use of the device does not result to a...

  • Red blood cell transfusion in non-bleeding critically ill patients with moderate anemia: is there a benefit? Leal-Noval, Santiago; Muñoz-Gómez, Manuel; Jiménez-Sánchez, Mercedes; Cayuela, Aurelio; Leal-Romero, María; Puppo-Moreno, Antonio; Enamorado, Judy; Arellano-Orden, Victoria // Intensive Care Medicine;Mar2013, Vol. 39 Issue 3, p445 

    Purpose: This study was undertaken to investigate the efficacy of red blood cell transfusion (RBCT) at reversing the deleterious effects of moderate anemia in critically ill, non-bleeding patients. Methods: This was a retrospective, pair-matched (ratio 1:1) cohort study. Non-bleeding critically...

  • Red Blood Cell Transfusion in the Neurological ICU. Kumar, Monisha // Neurotherapeutics;Jan2012, Vol. 9 Issue 1, p56 

    Red blood cell transfusion (RBCT) is a common therapy used in the intensive care unit to treat anemia. However, due to deleterious side effects and questionable efficacy, the clinical benefit of RBCT in patients who are not actively bleeding is unclear. The results of randomized controlled...

  • Erythropoietin-receptor agonists in critically ill patients: a meta-analysis of randomized controlled trials. Zarychanski, Ryan; Turgeon, Alexis F.; McIntyre, Lauralyn; Fergusson, Dean A. // CMAJ: Canadian Medical Association Journal;9/25/2007, Vol. 177 Issue 7, p725 

    Introduction: Anemia and the need for red blood cell transfusions are common among patients admitted to intensive care units. Erythropoietin has been used to decrease the need for transfusions; however, its ability to improve clinical outcomes is unknown. We evaluated the effect of...

  • Transfusion practice in the ICU: When to transfuse? Vincent, J. L.; Yalavatti, G. // Indian Journal of Critical Care Medicine;Oct-Dec2003, Vol. 7 Issue 4, p237 

    Discusses about anemia and blood transfusion in the intensive care unit. Transfusion practices among the critically ill; Inverse correlation between the hemoglobin concentration and organ dysfunction; Relationship between blood transfusion and poor outcome.

  • Anemia Is a Risk Factor for Acute Kidney Injury and Long-Term Mortality in Critically Ill Patients. Seung Seok Han; Seon Ha Baek; Shin Young Ahn; Ho Jun Chin; Ki Young Na; Dong-Wan Chae; Sejoong Kim // Tohoku Journal of Experimental Medicine;Dec2015, Vol. 237 Issue 4, p287 

    Acute kidney injury (AKI) is a major health concern, because AKI is related with an increase in morbidity and mortality. Anemia is related to AKI in several clinical settings. However, the relationship between anemia and AKI and the effect of anemia on long-term mortality are unresolved in...

  • Packed Red Blood Cell Transfusions in Critically Ill Patients. Collins, Tara Ann // Critical Care Nurse;Feb2011, Vol. 31 Issue 1, p25 

    Anemia, which is prevalent in critically ill patients, often requires frequent blood transfusions. These blood transfusions are not without risks. A critical review of 6 studies shows an association between red blood cell transfusion and increased mortality. However, when disease state was...

  • Intravenous iron or placebo for anaemia in intensive care: the IRONMAN multicentre randomized blinded trial. Litton, Edward; Baker, Stuart; Erber, Wendy; Farmer, Shannon; Ferrier, Janet; French, Craig; Gummer, Joel; Hawkins, David; Higgins, Alisa; Hofmann, Axel; Keulenaer, Bart; McMorrow, Julie; Olynyk, John; Richards, Toby; Towler, Simon; Trengove, Robert; Webb, Steve // Intensive Care Medicine;Nov2016, Vol. 42 Issue 11, p1715 

    Purpose: Both anaemia and allogenic red blood cell transfusion are common and potentially harmful in patients admitted to the intensive care unit. Whilst intravenous iron may decrease anaemia and RBC transfusion requirement, the safety and efficacy of administering iron intravenously to...

  • Preoperative transcatheter arterial embolization of hypervascular metastatic tumors of long bones. Jae Hyun Kwon; Ji Hoon Shin; Jin-Hyoung Kim; Dong-Il Gwon; Hyun Ki Yoon; Gi-Young Ko; Kyu Bo Sung; Ho-Young Song // Acta Radiologica;Apr2010, Vol. 51 Issue 4, p396 

    Background: Complete resection of hypervascular metastatic tumors is often complicated by massive intraoperative blood loss. Purpose: To assess the technical success and clinical effectiveness of transcatheter arterial embolization (TAE) of hypervascular metastatic tumors of long bones to reduce...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics