Rawal Gautam, Kumar Raj, Yadav Sankalp, Singh Amrita
Respiratory Intensive Care, Max Super Specialty Hospital, Saket, New Delhi, India.
Department of Medicine & TB, Chest Clinic Moti Nagar, North Delhi Municipal Corporation, New Delhi, India.
J Crit Care Med (Targu Mures). 2016 Aug 10;2(3):109-114. doi: 10.1515/jccm-2016-0017. eCollection 2016 Jul.
Anemia in patients admitted to an intensive care unit is common and affects almost all critically ill patients. The intensivist is faced with the challenge of treating multifactorial etiologies, mainly bleeding and blood loss due to phlebotomy and decreased erythropoiesis. Red cell transfusion, the most common treatment for anemia, comes with associated risks, which may further reduce the chance of survival of these patients. The best evidence suggests the practice of restrictive RBC transfusion (transfusion at Hb<7 g/dl). In this article, the etiopathogenesis of the anemia in critically ill is reviewed, and current opinion on the pros and cons of various management strategies are discussed with emphasize on restrictive transfusion policy.
入住重症监护病房的患者贫血很常见,几乎影响所有危重症患者。重症监护医生面临着治疗多因素病因的挑战,主要是由于放血和红细胞生成减少导致的出血和失血。红细胞输血是贫血最常见的治疗方法,但存在相关风险,这可能会进一步降低这些患者的生存几率。最佳证据表明应采用限制性红细胞输血(血红蛋白<7 g/dl时输血)。本文综述了危重症患者贫血的病因发病机制,并讨论了各种管理策略的利弊,重点强调了限制性输血策略。