Blood Transfusion Practice in Critically Ill Patients and Clinical Outcomes/ Kritik Hastada Kan Transfuzyonu Uygulamasi ve Klinik Sonuclar

• Published in: Yogu︣n bakim dergisi Vol. 10; no. 3; p. 90
• Main Authors: Gonderen, Kamil, Gonderen, Aysun
• Format: Journal Article
• Language: English
• Published: AVES 01-12-2019
• Subjects: Blood transfusion; Glycosylated hemoglobin; Hemoglobins; Hospital patients; Medical research; Mortality; Physiological aspects
• ISSN: 1309-1689
• DOI: 10.33381/dcbybd.2019.2200

Aim: The aim of this study is to quantify the red blood cell (RBC) transfusion threshold in critically ill patients and to examine the relationship between RBC transfusion and clinical outcomes. Materials and Methods: Five hundred and twenty patients who were admitted to the internal medicine intensive care unit (ICU) between February 2018 and May 2019 were included in this study. The collected data included patients' demographic characteristics, admission diagnostic categories, co-morbidities, the ICU admission Simplified Acute Physiology Scores (SAPS) II, numbers of RBC transfusion, ICU admission and pretransfusion hemoglobin levels, and requirements of invasive mechanical ventilation and vasoactive drugs during the ICU stay. The primary endpoint of the study was to determine the RBC transfusion threshold in critically ill patients. Secondary outcomes were the ICU length of stay and mortality. Results: A total of 89 (17.1%) patients received RBC transfusion during the ICU stay. The transfusion threshold hemoglobin was 6.9 g/dL in transfused patients. Transfused patients had higher SAPS II scores at ICU admission than non-transfused patients (p<0.001). The number of patients requiring invasive mechanical ventilation and vasopressor support was higher in transfused patients (p<0.001). ICU mortality rates were higher in patients who had received RBC transfusion during the ICU stay than in those who did not (ICU mortality rates were 51.7% and 23.9%, respectively). Conclusion: This study showed that one-fifth of ICU patients received RBC transfusion during the ICU stay. Transfused patients had higher disease scores and lower hemoglobin levels on the day of ICU admission. Transfused patients stayed longer in the ICU and had higher mortality rates than non-transfused patients. Keywords: red blood cell transfusion, mortality, intensive care, critically ill patients Amac: Kritik hastalarda eritrosit suspansiyonu (ES) transfuzyonu esigini belirlemek ve ES transfuzyonunun klinik sonuclarla iliskisini incelemektir. Gerec ve Yontemler: Calismaya Subat 2018-Mayis 2019 arasinda Ic hastaliklari yogun bakim unitesinde (YBU) yatan 520 hasta alinmistir. Hastalarin demografik ozellikleri, yatis tanilari, ek hastaliklari, yogun bakim kabulunde hesaplanan Basitlestirilmis Akut Fizyoloji Skoru (SAPS) II puanlari, yogun bakima yatis anindaki ve transfuzyon oncesi hemoglobin seviyeleri, olum oranlari, mekanik ventilasyon ve vazopressor ihtiyaclari, YBU'de kalis sureleri kaydedilmistir. Calismanin birincil sonlanim noktasi, kritik hastalarimizdaki ES transfuzyon yapilma esiginin belirlenmesidir. Ikincil sonlanim noktasi ise yogun bakimda yatis suresi ve mortalitesidir. Bulgular: Hastalarin 89 (%17.1)'na ES transfuzyonu yapilmistir. Transfuzyon yapma esigi 6.9 g/dL olarak bulunmustur. ES transfuzyonu yapilan hastalar ile yapilmayan hastalar karsilastirildiginda SAPS II skoru daha yuksek, invaziv mekanik ventilasyon ve vazopressor uygulama orani daha fazla bulunmustur (p<0.001). Yogun bakim yatisinda transfuzyon yapilan hastalarin mortalite orani transfuzyon yapilmayan hastalara gore daha yuksek bulunmustur (%51.7 vs %23.9, p<0.001). Sonuc: Bu calismada yogun bakim hastalarinin beste birine YBU'de kalis suresi boyunca ES transfuzyonu yapildigi gosterilmistir. Transfuzyon yapilan hastalar daha yuksek hastalik skoruna ve yogun bakima yatis gununde daha dusuk hemoglobin seviyelerine sahip hastalardir. ES transfuzyonu yapilan hastalar yapilmayan hastalara gore YBU'de daha uzun kalis suresine ve daha yuksek olum oranina sahiptir. Anahtar Kelimeler: eritrosit suspansiyonu transfuzyonu, mortalite, yogun bakim, kritik hasta