OBJECTIVE: To document the prevalence of anemia among patients admitted to intensive care (ICU) and, among survivors, at ICU discharge when restrictive transfusion practice was used. DESIGN: This was an observational cohort study. SETTING: Ten of the 26 general ICUs in Scotland. PATIENTS AND PARTICIPANTS: One thousand twenty-three sequential ICU admissions over 100 days, representing 44% of all ICU admissions in Scotland during the study period, studied daily from admission to discharge or death in the ICU. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: The median transfusion trigger used, in the absence of bleeding, was 78 g/l (interquartile range 73-84); <2% of transfusion triggers were above the upper limit of the national transfusion trigger guideline (100 g/l). Overall, 25% of admissions had a hemoglobin concentration <90 g/l at ICU admission. Seven hundred sixty-six patients admitted survived to ICU discharge. Among these, the prevalence of anemia (male <130 g/l; female <115 g/l) at ICU discharge was 87.0 (95% CI: 83.6 to 89.9)% for males and 79.6 (74.8 to 83.7)% for females. Of the male survivors 24.1 (20.3 to 28.3)% and of the female 27.9 (23.4 to 33.2)% had a hemoglobin <90 g/l at ICU discharge. The prevalence was similar for patients with and without pre-existing ischemic heart disease. Logistic regression found independent associations between having a hemoglobin concentration <90 g/l at ICU discharge and the first measured hemoglobin in ICU, the presence of acute renal failure and thrombocytopenia during ICU stay. CONCLUSIONS: Anemia is highly prevalent in ICUs that use restrictive transfusion triggers. The impact of anemia on functional recovery after intensive care requires investigation.
OBJECTIVE: To document the prevalence of anemia among patients admitted to intensive care (ICU) and, among survivors, at ICU discharge when restrictive transfusion practice was used. DESIGN: This was an observational cohort study. SETTING: Ten of the 26 general ICUs in Scotland. PATIENTS AND PARTICIPANTS: One thousand twenty-three sequential ICU admissions over 100 days, representing 44% of all ICU admissions in Scotland during the study period, studied daily from admission to discharge or death in the ICU. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: The median transfusion trigger used, in the absence of bleeding, was 78 g/l (interquartile range 73-84); <2% of transfusion triggers were above the upper limit of the national transfusion trigger guideline (100 g/l). Overall, 25% of admissions had a hemoglobin concentration <90 g/l at ICU admission. Seven hundred sixty-six patients admitted survived to ICU discharge. Among these, the prevalence of anemia (male <130 g/l; female <115 g/l) at ICU discharge was 87.0 (95% CI: 83.6 to 89.9)% for males and 79.6 (74.8 to 83.7)% for females. Of the male survivors 24.1 (20.3 to 28.3)% and of the female 27.9 (23.4 to 33.2)% had a hemoglobin <90 g/l at ICU discharge. The prevalence was similar for patients with and without pre-existing ischemic heart disease. Logistic regression found independent associations between having a hemoglobin concentration <90 g/l at ICU discharge and the first measured hemoglobin in ICU, the presence of acute renal failure and thrombocytopenia during ICU stay. CONCLUSIONS:Anemia is highly prevalent in ICUs that use restrictive transfusion triggers. The impact of anemia on functional recovery after intensive care requires investigation.
Authors: Craig J French; Rinaldo Bellomo; Simon R Finfer; Jeffery Lipman; Marianne Chapman; Neil W Boyce Journal: Med J Aust Date: 2002-11-18 Impact factor: 7.738
Authors: Tamara B Horwich; Gregg C Fonarow; Michele A Hamilton; W Robb MacLellan; Jeff Borenstein Journal: J Am Coll Cardiol Date: 2002-06-05 Impact factor: 24.094
Authors: T S Walsh; D B McClelland; R J Lee; M Garrioch; C R Maciver; F McArdle; S L Crofts; I Mellor Journal: Br J Anaesth Date: 2005-02-11 Impact factor: 9.166
Authors: Margaret S Herridge; Angela M Cheung; Catherine M Tansey; Andrea Matte-Martyn; Natalia Diaz-Granados; Fatma Al-Saidi; Andrew B Cooper; Cameron B Guest; C David Mazer; Sangeeta Mehta; Thomas E Stewart; Aiala Barr; Deborah Cook; Arthur S Slutsky Journal: N Engl J Med Date: 2003-02-20 Impact factor: 91.245
Authors: Howard L Corwin; Andrew Gettinger; Ronald G Pearl; Mitchell P Fink; Mitchell M Levy; Edward Abraham; Neil R MacIntyre; M Michael Shabot; Mei-Sheng Duh; Marc J Shapiro Journal: Crit Care Med Date: 2004-01 Impact factor: 7.598
Authors: Peter Andrews; Elie Azoulay; Massimo Antonelli; Laurent Brochard; Christian Brun-Buisson; Daniel De Backer; Geoffrey Dobb; Jean-Yves Fagon; Herwig Gerlach; Johan Groeneveld; Duncan Macrae; Jordi Mancebo; Philipp Metnitz; Stefano Nava; Jerôme Pugin; Michael Pinsky; Peter Radermacher; Christian Richard Journal: Intensive Care Med Date: 2007-02-14 Impact factor: 17.440
Authors: Santiago Ramón Leal-Noval; María Dolores Rincón-Ferrari; Ana Marin-Niebla; Aurelio Cayuela; Victoria Arellano-Orden; Antonio Marín-Caballos; Rosario Amaya-Villar; Carmen Ferrándiz-Millón; Francisco Murillo-Cabeza Journal: Intensive Care Med Date: 2006-09-22 Impact factor: 17.440
Authors: Letitia E Bible; Latha V Pasupuleti; Amy V Gore; Ziad C Sifri; Kolenkode B Kannan; Alicia M Mohr Journal: J Trauma Acute Care Surg Date: 2015-07 Impact factor: 3.313
Authors: Andreas Pape; Harry Kertscho; Jens Meier; Oliver Horn; Mohamed Laout; Max Steche; Mischa Lossen; Alf Theisen; Bernhard Zwissler; Oliver Habler Journal: Intensive Care Med Date: 2008-04-02 Impact factor: 17.440