A Cohort Study in Intensive Care Units: Health Decisions Related to Blood Transfusion during the COVID-19 Pandemic.

Autor: Juárez-Vela R; Doctoral Program in Medicine and Surgery, Faculty of Medicine, Autonomous University of Madrid, 28049 Madrid, Spain.; Research Group in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, C/Duquesa Victoria 88, 26006 Logrono, Spain.; Blood Management Patient Group, Research Institute Idi-Paz, 28046 Madrid, Spain., García-Erce JA; Blood Management Patient Group, Research Institute Idi-Paz, 28046 Madrid, Spain.; Bank of Blood and Tissue of Navarra, Government of Navarra, 31008 Pamplona, Spain., Gea-Caballero V; Blood Management Patient Group, Research Institute Idi-Paz, 28046 Madrid, Spain.; Faculty of Health Sciences, Valencian International University, 46002 Valencia, Spain., Ruiz de Viñaspre-Hernandez R; Research Group in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, C/Duquesa Victoria 88, 26006 Logrono, Spain., Santos-Sánchez JÁ; Faculty of Medicine, University of Salamanca, 37008 Salamanca, Spain.; Salamanca Hospital Complex, 37008 Salamanca, Spain., Sánchez-González JL; Faculty of Nursing and Physiotherapy, University of Salamanca, 37008 Salamanca, Spain., Andrés-Esteban EM; Blood Management Patient Group, Research Institute Idi-Paz, 28046 Madrid, Spain.; Department of Business Economics and Applied Economy, Faculty of Legal and Economic Sciences, University Rey Juan Carlos, 28032 Madrid, Spain., Czapla M; Research Group in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, C/Duquesa Victoria 88, 26006 Logrono, Spain.; Department of Emergency Medical Service, Wroclaw Medical University, 51-616 Wroclaw, Poland.; Institute of Heart Diseases, University Hospital, 50-566 Wroclaw, Poland., Tejada CI; Research Group in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, C/Duquesa Victoria 88, 26006 Logrono, Spain., Nanwani-Nanwani KL; Blood Management Patient Group, Research Institute Idi-Paz, 28046 Madrid, Spain.; La Paz Hospital Intensive Care Unit, 28046 Madrid, Spain., Serrano-Lázaro A; Blood Management Patient Group, Research Institute Idi-Paz, 28046 Madrid, Spain.; Intensive Care Unit, Hospital Clinico de Valencia, 46010 Valencia, Spain., Quintana-Díaz M; Doctoral Program in Medicine and Surgery, Faculty of Medicine, Autonomous University of Madrid, 28049 Madrid, Spain.; Blood Management Patient Group, Research Institute Idi-Paz, 28046 Madrid, Spain.; La Paz Hospital Intensive Care Unit, 28046 Madrid, Spain.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2022 Jul 28; Vol. 11 (15). Date of Electronic Publication: 2022 Jul 28.
DOI: 10.3390/jcm11154396
Abstrakt: Critically ill polytrauma patients with hemorrhage require a rapid assessment to initiate hemostatic resuscitation in the shortest possible time with the activation of a massive transfusion or a critical hemorrhage management protocol. The hospital reality experienced during the COVID-19 pandemic in all countries was critical, as it was in Spain; according to the data published daily by the Ministry of Health on its website, during the period of this study, the occupancy rate of intensive care units (ICUs) by patients diagnosed with the novel coronavirus disease (COVID-19) rose to 23.09% in Spain, even reaching 45.23% at the end of January 2021. We aimed to analyze the changes observed during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic period regarding the effectiveness of Spanish ICUs in terms of mortality reduction. We present a cross-sectional study that compares two cohorts of patients admitted to ICUs across all autonomous communities of Spain with a diagnosis of polytrauma. Results: Only age was slightly higher at admission during the first wave of the pandemic (47.74 ± 18.65 vs. 41.42 ± 18.82 years, p = 0.014). The transfusion rate during the pandemic increased by 10.4% compared to the previous stage ( p = 0.058). Regarding hemostatic components, the use of tranexamic acid increased from 1.8% to 10.7% and fibrinogen concentrates from 0.9% to 1.9%. In the case of prothrombin complex concentrates, although there was a slight increase in their use, there were no significant differences during the pandemic compared to the previous period. Conclusion: Mortality showed no difference before and during the pandemic, despite the observed change in the transfusion policy. In summary, the immediate and global implementation of patient blood management (PBM) based on clinical transfusion algorithms should be mandatory in all hospitals in our country.
Databáze: MEDLINE
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