red blood cell transfusion in the critically ill patient在危重病人红细胞输血.pdfVIP

Lelubre and Vincent Annals of Intensive Care 2011, 1:43 /content/1/1/43 REVIEW Open Access Red blood cell transfusion in the critically ill patient * Christophe Lelubre and Jean-Louis Vincent Abstract Red blood cell (RBC) transfusion is a common intervention in intensive care unit (ICU) patients. Anemia is frequent in this population and is associated with poor outcomes, especially in patients with ischemic heart disease. Although blood transfusions are generally given to improve tissue oxygenation, they do not systematically increase oxygen consumption and effects on oxygen delivery are not always very impressive. Blood transfusion may be lifesaving in some circumstances, but many studies have reported increased morbidity and mortality in transfused patients. This review focuses on some important aspects of RBC transfusion in the ICU, including physiologic considerations, a brief description of serious infectious and noninfectious hazards of transfusion, and the effects of RBC storage lesions. Emphasis is placed on the importance of personalizing blood transfusion according to physiological endpoints rather than arbitrary thresholds. Introduction cohort study in Scotland, 25% of patients admitted to Red blood cell (RBC) transfusion is commonly required in the ICU had a hemoglobin level 9 g/dl [2]. Similar critically ill patients. Several recent, observational, multi- results were reported in the ABC study [3], in which center studies reported that approximately one third of 29% of patients had a hemoglobin concentration 10 g/ critically ill patients received a blood transfusion at one dl on admission. Even in non