[Transfusion practices in brazilian Intensive Care Units (pelo FUNDO-AMIB)].

Autor:	Lobo SM; Faculdade de Medicina de São José do Rio Preto, SP., Vieira SR; HC de Porto Alegre, Departamento de Medicina Interna, UFRGS, RS, Brasil., Knibel MF; CTI dos Hospitais Cardiotrauma Ipanema e São Lucas, UFRJ, RJ., Grion CM; Universidade Estadual de Londrina., Friedman G; UTI Central do Complexo Hospitalar Santa Casa, HCPA, FAMED, UFRGS., Valiatti JL; Faculdade de Medicina de Catanduva., Machado FR; Setor de Terapia, Disciplina de Anestesiologia, Dor e Terapia Intensiva, Universidade Federal de São Paulo., Chiavone PA; Santa Casa de Misericórdia de São Paulo., Paciência LE; AMIB., Paula Jd; AMIB., Guimarães SM; Departamento de Medicina, AMIB., Costa JL; American College., Costa Filho RC; Hospital Pró Cardíaco., Borges GA; AMIB., Gama HC; Unidade coronariana, Hospital evangélico de Cachoeiro de Itapemirim, ES., Grilo MG; SBN., Torres KP; UFRJ., Franco RS; AMIB., Pinto JE; AMIB., David CM; AMIB.
Jazyk:	portugalština
Zdroj:	Revista Brasileira de terapia intensiva [Rev Bras Ter Intensiva] 2006 Sep; Vol. 18 (3), pp. 234-41.
Abstrakt:	Background and Objectives: Anemia of critical illness is a multifactorial condition caused by blood loss, frequent phlebotomies and inadequate production of red blood cells (RBC). Controversy surrounds the most appropriate hemoglobin concentration "trigger" for transfusion of RBC. We aimed to evaluate transfusion practices in Brazilian ICUs. Methods: A prospective study throughout a 2-week period in 19 Brazilian ICUs. Hemoglobin (Hb) level, transfusion rate, organ dysfunction assessment and 28-day mortality were evaluated. Primary indication for transfusion and pretransfusion hemoglobin level were collected for each transfusion. Results: Two hundred thirty-one patients with an ICU length of stay longer than 48h were included. An Hb level lower than 10 g/dL was found in 33% on admission in the ICU. A total of 348 RBC units were transfused in 86 patients (36.5%). The mean pretransfusion hemoglobin level was 7.7 ± 1.1 g/dL. Transfused-patients had significantly higher SOFA score (7.9 ± 4.6 vs 5.6 ± 3.8, p < 0.05, respectively), days on mechanical ventilation (10.7 ± 8.2 vs 7.2 ± 6.4, p < 0.05) and days on vasoactive drugs (6.7 ± 6.4 vs 4.2 ± 4.0, p < 0.05) than non-transfused patients despite similar APACHE II scores (15.2 ± 8.1 vs 14.2 ± 8.1, NS). Transfused patients had higher mortality rate (43.5%) than non-transfused patients (36.3%) (RR 0.60-1.15, NS). Only one patient (0.28%) had febrile non-hemolytic transfusion and urticarial reactions. Conclusions: Anemia is common in critically ill patients.It seems from the present study that transfusion practices in Brazil have had a more restrictive approach with a lower limit "transfusion trigger".
Databáze:	MEDLINE
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