Red blood cell transfusion in septic shock - clinical characteristics and outcome of unselected
patients in a prospective, multicentre cohort
Engelsk titel: Red blood cell transfusion in septic shock - clinical characteristics and outcome of unselected
patients in a prospective, multicentre cohort
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Författare:
Rosland, Ragnhild G
;
Hagen, Marte U
;
Haase, Nicolai
;
Holst, Lars B
;
Plambech, Morten
;
Madsen, Kristian R
;
Söe-Jensen, Peter
;
Poulsen, Lone M
;
Bestle, Morten
;
Perner, Anders
Email: anders.perner@regionh.dk
Språk: Eng
Antal referenser: 21
Dokumenttyp:
RCT
UI-nummer: 14129110
Sammanfattning
BACKGROUND:
Treating anaemia with red blood cell (RBC) transfusion is frequent, but controversial, in patients with
septic shock. Therefore we assessed characteristics and outcome associated with RBC transfusion
in this group of high risk patients.
METHODS:
We did a prospective cohort study at 7 general intensive care units (ICUs) including all adult patients
with septic shock in a 5-month period.
RESULTS:
Ninety-five of the 213 included patients (45%) received median 3 (interquartile range 2-5) RBC units
during shock. The median pre-transfusion haemoglobin level was 8.1 (7.4-8.9) g/dl and independent
of shock day and bleeding. Patients with cardiovascular disease were transfused at higher
haemoglobin levels. Transfused patients had higher Simplified Acute Physiology Score (SAPS) II (56
(45-69) vs. 48 (37-61), p = 0.0005), more bleeding episodes, lower haemoglobin levels days 1 to 5,
higher Sepsis-related Organ Failure Assessment (SOFA) scores (days 1 and 5), more days in shock (5
(3-10) vs. 2 (2-4), p = 0.0001), more days in ICU (10 (4-19) vs. 4 (2-8), p = 0.0001) and higher 90-day
mortality (66 vs. 43%, p = 0.001). The latter association was lost after adjustment for admission
category and SAPS II and SOFA-score on day 1.
CONCLUSIONS:
The decision to transfuse patients with septic shock was likely affected by disease severity and
bleeding, but haemoglobin level was the only measure that consistently differed between transfused
and non-transfused patients.