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首页> 外文期刊>Sao Paulo Medical Journal >Red blood cell transfusions worsen the outcomes even in critically ill patients undergoing a restrictive transfusion strategy
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Red blood cell transfusions worsen the outcomes even in critically ill patients undergoing a restrictive transfusion strategy

机译：红细胞输注甚至使危重患者接受限制性输注策略也使结果恶化

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CONTEXT AND OBJECTIVE: Anemia and blood transfusions are common in intensive care. This study aimed to evaluate epidemiology and outcomes among critically ill patients under a restrictive transfusion strategy. DESIGN AND SETTING: Prospective observational cohort study in an intensive care unit (ICU) at a tertiary hospital. METHODS: All adults admitted to the ICU over a one-year period who remained there for more than 72 hours were included, except those with acute coronary syndrome, ischemic stroke, acute hemorrhage, prior transfusion, pregnant women and Jehovah's Witnesses. The restrictive strategy consisted of transfusion indicated when hemoglobin levels were less than or equal to 7.0 g/dl. RESULTS: The study enrolled 167 patients; the acute physiology and chronic health evaluation II (APACHE II) score was 28.9 ± 6.5. The baseline hemoglobin level was 10.6 ± 2.2 g/dl and on day 28, it was 8.2 ± 1.3 g/dl (P < 0.001). Transfusions were administered to 35% of the patients. In the transfusion group, 61.1% did not survive, versus 48.6% in the non-transfusion group (P = 0.03). Transfusion was an independent risk factor for mortality (P = 0.011; odds ratio, OR = 2.67; 95% confidence interval, CI = 1.25 to 5.69). ICU stay and hospital stay were longer in the transfusion group: 20.0 (3.0-83.0) versus 8.0 (3.0-63.0) days (P < 0,001); and 24.0 (3.0-140.0) versus 14.0 (3.0-80.0) days (P = 0.002), respectively. CONCLUSIONS: In critically ill patients, there was a reduction in hemoglobin with increasing length of ICU stay. Moreover, transfusion was associated with worse prognoses.
机译：背景与目的：重症监护病房常见贫血和输血。这项研究旨在评估在限制性输血策略下危重患者的流行病学和预后。设计与地点：在一家三级医院的重症监护室（ICU）进行前瞻性观察队列研究。方法：除患有急性冠状动脉综合征，局部缺血性中风，急性出血，事先输血，孕妇和耶和华见证人的患者外，纳入所有在ICU住院一年以上且超过72小时的成年人。限制性策略包括当血红蛋白水平小于或等于7.0 g / dl时指示输血。结果：该研究招募了167例患者。急性生理和慢性健康评估II（APACHE II）评分为28.9±6.5。基线血红蛋白水平为10.6±2.2 g / dl，在第28天为8.2±1.3 g / dl（P <0.001）。 35％的患者接受了输血。在输血组中，61.1％的患者没有存活，而在非输血组中，48.6％（P = 0.03）。输血是死亡的独立危险因素（P = 0.011;优势比，OR = 2.67; 95％置信区间，CI = 1.25至5.69）。输血组的ICU住院时间和住院时间更长：20.0（3.0-83.0）天vs 8.0（3.0-63.0）天（P <0,001）;和24.0（3.0-140.0）天与14.0（3.0-80.0）天（P = 0.002）。结论：在重症患者中，随着ICU住院时间的延长，血红蛋白减少。此外，输血与预后差有关。

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