de Paula Ilusca Cardoso, Azevedo Luciano Cesar Pontes, Falcão Luiz Fernando dos Reis, Mazza Bruno Franco, Barros Melca Maria Oliveira, Freitas Flavio Geraldo Rezende, Machado Flávia Ribeiro
Setor de Terapia Intensiva, Disciplina de Anestesiologia, Dor e Medicina Intensiva da Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Disciplina de Hematologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Braz J Anesthesiol. 2014 May-Jun;64(3):183-9. doi: 10.1016/j.bjane.2013.07.012. Epub 2014 Feb 14.
anemia is a common clinical finding in intensive care units. The red blood cell transfusion is the main form of treatment, despite the associated risks. Thus, we proposed to evaluate the profile of transfusional patients in different intensive care units.
prospective analysis of patients admitted in the intensive care units of a tertiary university hospital with an indication for transfusion of packed red blood cells. Demographic profile and transfusional profile were collected, a univariate analysis was done, and the results were considered significant at p ≤ 0.05.
408 transfusions were analyzed in 71 patients. The mean hemoglobin concentration on admission was 9.7 ± 2.3g/dL and the pre-transfusional concentration was 6.9 ± 1.1g/dL. The main indications for transfusion were hemoglobin concentration (49%) and active bleeding (32%). The median number of units transfused per episode was 2 (1-2) and the median storage time was 14 (7-21) days. The number of patients transfused with hemoglobin levels greater than 7 g/dL and the number of bags transfused per episode were significantly different among intensive care units. Patients who received three or more transfusions had longer mechanical ventilation time and intensive care unit stay and higher mortality after 60 days. There was an association of mortality with disease severity but not with transfusional characteristics.
the practice of blood products transfusion was partially in agreement with the guidelines recommended, although there are differences in behavior between the different profiles of intensive care units. Transfused patients evolved with unfavorable outcomes. Despite the scarcity of blood in blood banks, the mean storage time of the bags was high.
贫血是重症监护病房常见的临床症状。尽管存在相关风险，但红细胞输血仍是主要的治疗方式。因此，我们提议评估不同重症监护病房输血患者的情况。
对一所三级大学医院重症监护病房收治的有浓缩红细胞输血指征的患者进行前瞻性分析。收集人口统计学资料和输血情况，进行单因素分析，结果以p≤0.05为有统计学意义。
对71例患者的408次输血进行了分析。入院时平均血红蛋白浓度为9.7±2.3g/dL，输血前浓度为6.9±1.1g/dL。输血的主要指征是血红蛋白浓度（49%）和活动性出血（32%）。每次输血的单位数中位数为2（1 - 2），储存时间中位数为14（7 - 21）天。不同重症监护病房中，血红蛋白水平大于7g/dL的输血患者数量以及每次输血的袋数存在显著差异。接受三次或更多次输血的患者机械通气时间和重症监护病房住院时间更长，60天后死亡率更高。死亡率与疾病严重程度有关，而与输血特征无关。
血液制品的输血实践部分符合推荐的指南，尽管不同类型的重症监护病房之间存在行为差异。输血患者的预后不佳。尽管血库血液短缺，但血袋的平均储存时间较长。
