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Published in: Critical Care 4/2002

01-08-2002 | Commentary

ICU Cornerstone: Changing our view of blood transfusions

Authors: Warren L Lee, Gregory P Downey

Published in: Critical Care | Issue 4/2002

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Abstract

Blood transfusions are commonly administered to critically ill patients, but deciding when to transfuse a particular patient is often difficult and necessitates careful consideration of both the potential benefits and risks. This commentary briefly discusses some of the considerations both for and against blood transfusion in the setting of critical illness and reviews a landmark clinical trial in this area. Finally, we reflect on the changes in attitudes towards the transfusion of blood and blood products that have taken place over the last 20 years.
Literature
2.
go back to reference Czer LSC, Shoemaker WC: Optimal hematocrit value in critically ill postoperative patients. Surg Gynecol Obstet 1978, 147: 363-368.PubMed Czer LSC, Shoemaker WC: Optimal hematocrit value in critically ill postoperative patients. Surg Gynecol Obstet 1978, 147: 363-368.PubMed
3.
go back to reference Corwin HL, Parsonnet KC, Gettinger A: RBC transfusion in the ICU – is there a reason? Chest 1995, 108: 767-771.CrossRefPubMed Corwin HL, Parsonnet KC, Gettinger A: RBC transfusion in the ICU – is there a reason? Chest 1995, 108: 767-771.CrossRefPubMed
4.
go back to reference Russell JA, Phang PT: The oxygen delivery/consumption controversy–approaches to management of the critically ill. Am J Respir Crit Care Med 1994, 149: 533-537.CrossRefPubMed Russell JA, Phang PT: The oxygen delivery/consumption controversy–approaches to management of the critically ill. Am J Respir Crit Care Med 1994, 149: 533-537.CrossRefPubMed
5.
go back to reference Hayes MA, Timmins AC, Yau EHS, Palazzo M, Hinds CJ, Watson D: Elevation of systemic oxygen delivery in the treatment of critically ill patients. N Engl J Med 1994, 330: 1717-1722. 10.1056/NEJM199406163302404CrossRefPubMed Hayes MA, Timmins AC, Yau EHS, Palazzo M, Hinds CJ, Watson D: Elevation of systemic oxygen delivery in the treatment of critically ill patients. N Engl J Med 1994, 330: 1717-1722. 10.1056/NEJM199406163302404CrossRefPubMed
6.
go back to reference Gattinoni L, Brazzi L, Pelosi P, Latini R, Tognoni G, Pesenti A, Fumagalli R, for the SvO2 Collaborative Group: A trial of goal-oriented hemodynamic therapy in critically ill patients. N Engl J Med 1995, 333: 1025-1032. 10.1056/NEJM199510193331601CrossRefPubMed Gattinoni L, Brazzi L, Pelosi P, Latini R, Tognoni G, Pesenti A, Fumagalli R, for the SvO2 Collaborative Group: A trial of goal-oriented hemodynamic therapy in critically ill patients. N Engl J Med 1995, 333: 1025-1032. 10.1056/NEJM199510193331601CrossRefPubMed
7.
go back to reference Lorente JA, Landin L, De Pablo R, Renes E, Rodriguez-Diaz R, Liste D: Effects of blood transfusion on oxygen transport variables in severe sepsis. Crit Care Med 1993, 21: 1312-1318.CrossRefPubMed Lorente JA, Landin L, De Pablo R, Renes E, Rodriguez-Diaz R, Liste D: Effects of blood transfusion on oxygen transport variables in severe sepsis. Crit Care Med 1993, 21: 1312-1318.CrossRefPubMed
8.
go back to reference Dietrich KA, Conrad SA, Hebert CA, Levy GL, Romero MD: Cardiovascular and metabolic response to red blood cell transfusion in critically ill volume-resuscitated nonsurgical patients. Crit Care Med 1990, 18: 940-944.CrossRefPubMed Dietrich KA, Conrad SA, Hebert CA, Levy GL, Romero MD: Cardiovascular and metabolic response to red blood cell transfusion in critically ill volume-resuscitated nonsurgical patients. Crit Care Med 1990, 18: 940-944.CrossRefPubMed
9.
go back to reference Jenson LS, Anderson AJ, Christiansen PM, Hokland P, Juhl CO, Madsen G: Postoperative infection and natural killer cell function following transfusion in patients undergoing elective colorectal surgery. Br J Surg 1992, 79: 513-516.CrossRef Jenson LS, Anderson AJ, Christiansen PM, Hokland P, Juhl CO, Madsen G: Postoperative infection and natural killer cell function following transfusion in patients undergoing elective colorectal surgery. Br J Surg 1992, 79: 513-516.CrossRef
10.
go back to reference Marik PE, Sibbald WJ: Effect of stored-blood transfusion on oxygen delivery in patients with sepsis. JAMA 1993, 269: 3024-3029. 10.1001/jama.269.23.3024CrossRefPubMed Marik PE, Sibbald WJ: Effect of stored-blood transfusion on oxygen delivery in patients with sepsis. JAMA 1993, 269: 3024-3029. 10.1001/jama.269.23.3024CrossRefPubMed
11.
go back to reference Hébert PC, Wells G, Martin C, Tweeddale M, Marshall J, Blajch-man M, Pagliarello G, Schweitzer I, Calder L: A Canadian survey of transfusion practices in critically ill patients. Crit Care Med 1998, 26: 482-487. 10.1097/00003246-199803000-00019CrossRefPubMed Hébert PC, Wells G, Martin C, Tweeddale M, Marshall J, Blajch-man M, Pagliarello G, Schweitzer I, Calder L: A Canadian survey of transfusion practices in critically ill patients. Crit Care Med 1998, 26: 482-487. 10.1097/00003246-199803000-00019CrossRefPubMed
12.
go back to reference Hébert PC, Wells G, Blajchman MA, Marshall J, Martin C, Pagliarello G, Tweeddale M, Schweitzer I, Yetisir E, and the Transfusion Requirements in Critical Care Investigators for the Canadian Critical Care Trials Group: A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. N Engl J Med 1999, 340: 409-417. 10.1056/NEJM199902113400601CrossRefPubMed Hébert PC, Wells G, Blajchman MA, Marshall J, Martin C, Pagliarello G, Tweeddale M, Schweitzer I, Yetisir E, and the Transfusion Requirements in Critical Care Investigators for the Canadian Critical Care Trials Group: A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. N Engl J Med 1999, 340: 409-417. 10.1056/NEJM199902113400601CrossRefPubMed
13.
go back to reference McCrossan L, Masterson G: Blood transfusion in critical illness. Br J Anaesth 2002, 88: 6-9. 10.1093/bja/88.1.6CrossRefPubMed McCrossan L, Masterson G: Blood transfusion in critical illness. Br J Anaesth 2002, 88: 6-9. 10.1093/bja/88.1.6CrossRefPubMed
14.
go back to reference Hébert PC, Yetisir E, Martin C, Blajchman MA, Wells G, Marshall J, Tweeddale M, Pagliarello G, Schweitzer I, and the Transfusion Requirements in Critical Care Investigators for the Canadian Critical Care Trials Group: Is a low transfusion threshold safe in critically ill patients with cardiovascular diseases? Crit Care Med 2001, 29: 227-234. 10.1097/00003246-200102000-00001CrossRefPubMed Hébert PC, Yetisir E, Martin C, Blajchman MA, Wells G, Marshall J, Tweeddale M, Pagliarello G, Schweitzer I, and the Transfusion Requirements in Critical Care Investigators for the Canadian Critical Care Trials Group: Is a low transfusion threshold safe in critically ill patients with cardiovascular diseases? Crit Care Med 2001, 29: 227-234. 10.1097/00003246-200102000-00001CrossRefPubMed
15.
go back to reference Dorozynski A: Tainted blood affair threatens French Government. Br Med J 1992, 14: 1177. Dorozynski A: Tainted blood affair threatens French Government. Br Med J 1992, 14: 1177.
16.
go back to reference Watts J: Japanese official found guilty in HIV-blood trial. Lancet 2001, 358: 1166. 10.1016/S0140-6736(01)06317-6CrossRefPubMed Watts J: Japanese official found guilty in HIV-blood trial. Lancet 2001, 358: 1166. 10.1016/S0140-6736(01)06317-6CrossRefPubMed
17.
go back to reference Capen K: Informed consent and blood transfusions: What does Krever's interim report mean to doctors? CMAJ 1995, 152: 1663-1665.PubMedCentralPubMed Capen K: Informed consent and blood transfusions: What does Krever's interim report mean to doctors? CMAJ 1995, 152: 1663-1665.PubMedCentralPubMed
18.
go back to reference Mann R, Heimbach DM, Engrav LH, Foy H: Changes in transfusion practices in burn patients. J Trauma 1994, 37: 220-222.CrossRefPubMed Mann R, Heimbach DM, Engrav LH, Foy H: Changes in transfusion practices in burn patients. J Trauma 1994, 37: 220-222.CrossRefPubMed
19.
go back to reference Farion KJ, McLellan BA, Boulanger BR, Szalai JP: Changes in red cell transfusion practice among adult trauma victims. J Trauma 1998, 44: 583-587.CrossRefPubMed Farion KJ, McLellan BA, Boulanger BR, Szalai JP: Changes in red cell transfusion practice among adult trauma victims. J Trauma 1998, 44: 583-587.CrossRefPubMed
20.
go back to reference CDC: Possible transfusion-associated acquired immune deficiency syndrome (AIDS) – California. MMWR Morb Mortal Wkly Rep 2000, 31: 652-654. CDC: Possible transfusion-associated acquired immune deficiency syndrome (AIDS) – California. MMWR Morb Mortal Wkly Rep 2000, 31: 652-654.
Metadata
Title
ICU Cornerstone: Changing our view of blood transfusions
Authors
Warren L Lee
Gregory P Downey
Publication date
01-08-2002
Publisher
BioMed Central
Published in
Critical Care / Issue 4/2002
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc1512

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