Quintana-Diaz M, Nanwani-Nanwani K, Marcos-Neira P, Serrano-Lázaro A, Juarez-Vela R, Andrés-Esteban E M
Servicio de Medicina Intensiva, Hospital Universitario La Paz, Madrid, España; Grupo PBM, Instituto de Investigación-IdiPaz, Madrid, España.
Servicio de Medicina Intensiva, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España.
Med Intensiva (Engl Ed). 2020 Oct 18. doi: 10.1016/j.medin.2020.08.015.
To describe the transfusion practice in the ICUs in Spain, according to national and international recommendations (guidelines).
Prospective, cross-sectional, multi-centre study.
Data collection was carried out by means of a questionnaire sent electronically to the Heads of Service of 111 ICUs in Spain.
1,448 patients were included, aged 61.8 (SD 15.7) years, 66.2% male, with an SOFA of 4.7±3.8 and average stay of 10.62±17.49 days.
Demographic and clinical variables of the patients were collected, as well as variables related to the transfusion act.
Of the 1,448 patients, 9.9% received al least one transfusion of any blood product, 3.7% fresh plasma, 3.9% platelets and 8.9% red blood cell concentrate, mainly by analytical criteria (36.2%). Hemoglobin had a mean of 7.8g/dL (95% CI: 6-9-8.5) and 9.8g/dL (95% CI: 8.5-11.2) before and after the transfusion, respectively, p<0.001. The transfusion units had a mean of 2.5±2.4 per patient. The most commonly used blood product was red blood cell concentrate (90.2%). Patients admitted for surgery had a higher transfusion rate (14.4%) than those admitted for medical pathology (8.9%) (p=0.006). 5.4% (7/129) of patients who received red blood cell concentrate died compared to 2.4% (31/1302) who did not (p=0.04). Mortality of transfused patients was higher. The transfusion rate in most of hospitals was 5% to 20%, with 18 hospitals (16.21%) having transfusion rates between 20% and 50%. Hospitals with PBM programs and mass transfusion programs had a lower transfusion rate, although not statistically significant.
In this multicenter cross-sectional study, a transfusion prevalence of 9.9% was observed in Spanish critical care units. The most frequent blood product transfused was red blood cells and the main reasons for transfusion were acute anemia with hemodynamic impact and analytical criteria. Mortality of transfused patients was higher.
根据国家和国际建议（指南）描述西班牙重症监护病房（ICU）的输血情况。
前瞻性、横断面、多中心研究。
通过电子方式向西班牙111个ICU的科室主任发送问卷进行数据收集。
纳入1448例患者，年龄61.8（标准差15.7）岁，男性占66.2%，序贯器官衰竭评估（SOFA）评分为4.7±3.8，平均住院时间为10.62±17.49天。
收集患者的人口统计学和临床变量，以及与输血行为相关的变量。
在1448例患者中，9.9%至少接受过一次任何血液制品的输血，3.7%接受新鲜血浆输血，3.9%接受血小板输血，8.9%接受红细胞浓缩液输血，主要依据分析标准（36.2%）。输血前血红蛋白平均为7.8g/dL（95%置信区间：6.9 - 8.5），输血后为9.8g/dL（95%置信区间：8.5 - 11.2），p<0.001。每位患者输血单位平均为2.5±2.4个。最常用的血液制品是红细胞浓缩液（90.2%）。因手术入院的患者输血率（14.4%）高于因内科疾病入院的患者（8.9%）（p = 0.006）。接受红细胞浓缩液输血的患者中有5.4%（7/129）死亡，未接受输血的患者中有2.4%（31/1302）死亡（p = 0.04）。输血患者的死亡率更高。大多数医院的输血率为5%至20%，18家医院（16.21%）的输血率在20%至50%之间。实施患者血液管理（PBM）计划和大量输血计划的医院输血率较低，尽管无统计学意义。
在这项多中心横断面研究中，西班牙重症监护病房的输血患病率为9.9%。最常输注的血液制品是红细胞，输血的主要原因是具有血流动力学影响的急性贫血和分析标准。输血患者的死亡率更高。
