Format

Send to

Choose Destination
Chest. 1995 Sep;108(3):767-71.

RBC transfusion in the ICU. Is there a reason?

Author information

1
Critical Care Service, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.

Abstract

OBJECTIVE:

To evaluate RBC transfusion practice in the ICU.

DESIGN:

Retrospective chart review.

SETTING:

Multidisciplinary ICU in a tertiary care center.

PATIENTS:

All patients admitted to the ICU with a length of stay of greater than 1 week.

RESULTS:

A total of 23% of all patients admitted to the ICU had a length of stay of greater than 1 week (19.6 +/- 1.6 days). Of these patients, 85% received blood transfusions (9.5 +/- 0.8 U per patient). These transfusions were not solely a function of acute blood loss. Patients were transfused a constant 2 to 3 U/wk. Patients receiving blood transfusions were phlebotomized on average 61 to 70 mL per day. Phlebotomy accounted for 49% of the variation in amount of RBCs transfused. No indication for blood transfusion was identified for 29% of transfusion events. A low hematocrit (< 25%) was the only identifiable indication in an additional 19% of events. Almost one third of all RBCs transfused were without a clear transfusion indication.

CONCLUSION:

The long-term ICU population receive a large number of blood transfusions. Phlebotomy contributes significantly to these transfusions. There is no clear indication for a large number of the blood transfusions given. Many blood transfusions appear to be administered because of an arbitrary "transfusion trigger" rather than a physiologic need for blood. Blood conservation and adherence to transfusion guidelines could significantly reduce RBC transfusion in the ICU.

PMID:
7656631
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center