Biomaterial Database

Packed red blood cell transfusion in the intensive care unit: limitations and consequences. 2007

Suzanne Gould, and Mary Jo Cimino, and David R Gerber

Cooper University Hospital, Camden, NJ 08103, USA.

OBJECTIVE To review the literature on the limitations and consequences of packed red blood cell transfusions, with particular attention to critically ill patients. METHODS The PubMed database of the National Library of Medicine was searched to find published articles on the indications, clinical utility, limitations, and consequences of red blood cell transfusion, especially in critically ill patients. RESULTS Several dozen papers were reviewed, including case series, meta-analyses, and retrospective and prospective studies evaluating the physiological effects, clinical efficacy, and consequences and complications of transfusion of packed red blood cells. Most available data indicate that packed red blood cells have a very limited ability to augment oxygen delivery to tissues. In addition, the overwhelming preponderance of data accumulated in the past decade indicate that patients receiving such transfusions have significantly poorer outcomes than do patients not receiving such transfusions, as measured by a variety of parameters including, but not limited to, death and infection. CONCLUSIONS According to the available data, transfusion of packed red blood cells should be reserved only for situations in which clear physiological indicators for transfusion are present.

UI	MeSH Term	Description	Entries
D007362	Intensive Care Units	Hospital units providing continuous surveillance and care to acutely ill patients.	ICU Intensive Care Units,Intensive Care Unit,Unit, Intensive Care
D003422	Critical Care	Health care provided to a critically ill patient during a medical emergency or crisis.	Intensive Care,Intensive Care, Surgical,Surgical Intensive Care,Care, Critical,Care, Intensive,Care, Surgical Intensive
D004509	Education, Nursing, Continuing	Educational programs designed to inform nurses of recent advances in their fields.	Education, Nursing, Post-Basic,Education, Nursing, Post-Registration,Nursing Education, Continuing,Nursing Education, Post-Basic,Nursing Education, Post-Registration,Post-Basic Nursing Education,Post-Registration Nursing Education,Continuing Nursing Education,Education, Continuing Nursing,Education, Post-Basic Nursing,Education, Post-Registration Nursing,Nursing Education, Post Basic,Nursing Education, Post Registration,Post Basic Nursing Education,Post Registration Nursing Education
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000740	Anemia	A reduction in the number of circulating ERYTHROCYTES or in the quantity of HEMOGLOBIN.	Anemias
D016896	Treatment Outcome	Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.	Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D017410	Practice Guidelines as Topic	Works about directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery.	Clinical Guidelines as Topic,Best Practices,Best Practice
D017707	Erythrocyte Transfusion	The transfer of erythrocytes from a donor to a recipient or reinfusion to the donor.	Red Blood Cell Transfusion,Red Blood Cell Transfusions,Transfusion, Red Blood Cell,Transfusions, Red Blood Cell,Erythrocyte Transfusions,Transfusion, Erythrocyte,Transfusions, Erythrocyte
D018805	Sepsis	Systemic inflammatory response syndrome with a proven or suspected infectious etiology. When sepsis is associated with organ dysfunction distant from the site of infection, it is called severe sepsis. When sepsis is accompanied by HYPOTENSION despite adequate fluid infusion, it is called SEPTIC SHOCK.	Bloodstream Infection,Pyaemia,Pyemia,Pyohemia,Blood Poisoning,Poisoning, Blood,Septicemia,Severe Sepsis,Blood Poisonings,Bloodstream Infections,Infection, Bloodstream,Poisonings, Blood,Pyaemias,Pyemias,Pyohemias,Sepsis, Severe,Septicemias
D019317	Evidence-Based Medicine	An approach of practicing medicine with the goal to improve and evaluate patient care. It requires the judicious integration of best research evidence with the patient's values to make decisions about medical care. This method is to help physicians make proper diagnosis, devise best testing plan, choose best treatment and methods of disease prevention, as well as develop guidelines for large groups of patients with the same disease. (from JAMA 296 (9), 2006)	Medicine, Evidence-Based,Evidence Based Medicine,Medicine, Evidence Based