Use of blood components in critically ill patients in the medical intensive care unit of a tertiary care hospital

Makroo, R. N.; Mani, R. K.; Vimarsh, Raina; Kansal, Sudha; Pushkar, Kumar; Tyagi, Sandeep
July 2009
Asian Journal of Transfusion Science;Jul-Dec2009, Vol. 3 Issue 2, p82
Academic Journal
Background: The art of fluid administration and hemodynamic support is one of the most challenging aspects of treating critically ill patients. Transfusions of blood products continue to be an important technique for resuscitating patients in the intensive care settings. Concerns about the rate of inappropriate transfusion exist, particularly given the recognized risks of transfusions and the decreasing availability of donor blood. We investigated the current transfusion practice in the critically ill patients at our hospital. Materials and Methods: A total of 1817 consecutive critically ill patients admitted between January 2006 and December 2006 were included in this retrospective study. The blood request forms of the patients were analyzed, and their pretransfusion investigations, indications for transfusions, etc. were studied. Results: Nine hundred and eleven (50.1%) critically ill patients, comprising 71.6% males and 28.4% females, received blood/blood components. About 43.8% patients were administered packed red cells (PRC), 18.27% fresh frozen plasma (FFP) and 8.4% transfused platelets. Among those receiving PRC, 31.1% had a pretransfusion Hb below 7.5g%, 34.4% had Hb between 7.5 and 9g%, while 21.4% had Hb above 9g%. Among those receiving FFP, 14.5% had an international normalized ratio INR < 1.5, and 19% had a pretransfusion platelet count above 50,000/cumm. During the study, there were 7% of the patients who received red cells and FFP, 2% of the patients received red cells and platelets, 1% of the patients received platelets and FFP, and 5% of the patients had received all the three components, i.e., red cells, FFP and Platelets. The baseline investigations and/or clinical indications were not mentioned in 13.1% of patients receiving PRC, 57% receiving FFP and 49.7% receiving platelets. Conclusion: About 21.4% of PRC, 14.5% of FFP, and 19% of platelets were inappropriately indicated. Clinicians in our centre were conservative in keeping with recent transfusion guidelines. A significant number of blood request forms were still incomplete with baseline investigations not mentioned in the request forms.


Related Articles

  • Malária Grave Importada em Doentes Críticos. PALMA DOS REIS, Inês; SERAFIM, Catarina; VALÉRIO, Bernardino; ARAÚJO, Robson; SILVESTRE, Joana; MENDES, Vítor; TAPADINHAS, Camila; GONÇALVES PEREIRA, João; PÓVOA, Pedro // Acta Medica Portuguesa;set/out2012, Vol. 25 Issue 5, p271 

    Introduction: Imported malaria is a frequent diagnosis in Portugal, and in the most severe clinical forms it may present a high mortality rate. Material and Methods: We present seven cases of severe imported malaria, admitted to an intensive care unit between 2000 and 2010, with particular focus...

  • 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.

  • Association of cell-free plasma DNA with hospital mortality and organ dysfunction in intensive care unit patients. Saukkonen, Katri; Lakkisto, Päivi; Varpula, Marjut; Varpula, Tero; Voipio-Pulkki, Liisa-Maria; Pettilä, Ville; Pulkki, Kari // Intensive Care Medicine;Sep2007, Vol. 33 Issue 9, p1624 

    To investigate the concentration of cell-free plasma DNA and its association with organ dysfunction and hospital mortality in intensive care unit patients. Prospective cohort study in a medical and two medical-surgical intensive care units in a university hospital. 228 critically ill patients...

  • Temporal changes in muscle glutathione in ICU patients. Fläring, U. B.; Rooyackers, O. E.; Wernerman, J.; Hammarqvist, F. // Intensive Care Medicine;Dec2003, Vol. 29 Issue 12, p2193 

    Objective. This study investigated the changes over time in glutathione and its constituent amino acids in skeletal muscle of ICU patients with multiple organ failure. Design and setting. Prospective and descriptive pilot study in two medium-sized ICUs with ten beds. Patients. Critically ill...

  • Ionic dialysance: a new valid parameter for quantification of dialysis efficiency in acute renal failure? Ridel, Christophe; Osman, David; Mercadal, Lucile; Anguel, Nadia; Petitclerc, Thierry; Richard, Christian; Vinsonneau, Christophe // Intensive Care Medicine;Mar2007, Vol. 33 Issue 3, p460 

    Several studies have reported a close relationship between an increased dose of dialysis and survival in patients treated for acute renal failure. Unfortunately, the quantification of dialysis in critically ill patients based on the urea nitrogen formula Kt/V is not applicable. Ionic dialysance...

  • Modeling MODS: what can be learned from animal models of the multiple-organ dysfunction syndrome? Marshall, John C. // Intensive Care Medicine;May2005, Vol. 31 Issue 5, p605 

    Focuses on the complexity of multiple organ dysfunction syndrome (MODS). Threat faced by a critically ill patient with progressive impairment of physiological function involving a number of organ systems that may or may not have been directly affected by the original insult; Consideration of...

  • Multicenter study of the multiple organ dysfunction syndrome in intensive care units: the usefulness of Sequential Organ Failure Assessment scores in decision making. Cabr�, L.; Mancebo, J.; Solsona, J.; Saura, P.; Gich, I.; Blanch, L.; Carrasco, G.; Mart�n, M. // Intensive Care Medicine;Jul2005, Vol. 31 Issue 7, p927 

    Objective: This study examined the incidence and mortality of multiple organ dysfunction syndrome (MODS) in intensive care units, evaluated the limitation of life support in these patients, and determined whether daily measurement of the Sequential Organ Failure Assessment (SOFA) is useful for...

  • Altered Gut Flora Are Associated with Septic Complications and Death in Critically Ill Patients with Systemic Inflammatory Response Syndrome. Shimizu, Kentaro; Ogura, Hiroshi; Hamasaki, Toshimitsu; Goto, Miki; Tasaki, Osamu; Asahara, Takashi; Nomoto, Koji; Morotomi, Masami; Matsushima, Asako; Kuwagata, Yasuyuki; Sugimoto, Hisashi // Digestive Diseases & Sciences;Apr2011, Vol. 56 Issue 4, p1171 

    Background: Gut under severe insult is considered to have an important role in promoting infection and multiple organ dysfunction syndrome from the viewpoint of altered intestinal epithelium, immune system and commensal bacteria. There are few reports, however, about the relationship between gut...

  • Patterns and early evolution of organ failure in the intensive care unit and their relation to outcome. Sakr, Yasser; Lobo, Suzana M.; Moreno, Rui P.; Gerlach, Herwig; Ranieri, V. Marco; Michalopoulos, Argyris; Vincent, Jean-Louis // Critical Care;2012, Vol. 16 Issue 6, pR222 

    Introduction: Recognition of patterns of organ failure may be useful in characterizing the clinical course of critically ill patients. We investigated the patterns of early changes in organ dysfunction/failure in intensive care unit (ICU) patients and their relation to outcome. Methods: Using...


Read the Article


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

Try another library?
Sign out of this library

Other Topics