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• W2127116176 abstract "In the last decade or so, the practice of packed red blood cell (PRBC) transfusions in critically ill patients has become the subject of many investigations. Once regarded as a relatively safe and effective means of increasing oxygen delivery, it has become clear that there are several aspects of blood transfusion that are not understood completely. Many investigators and clinicians feel that more scrutiny of this practice is warranted given an increased awareness of blood-borne pathogens, evidence that allogeneic PRBCs may lower susceptibility to infection [ 1 Vamvakas E.C Blajchman M.A Deleterious clinical effects of transfusion-associated immunomodulation: fact or fiction?. Blood. 2001; 97: 1180-1195 Crossref PubMed Scopus (373) Google Scholar , 2 Vamvakas E.C Carven J.H Hibberd P.L Blood transfusion and infection after colorectal cancer surgery. Transfusion. 1996; 36: 1000-1008 Crossref PubMed Scopus (88) Google Scholar , 3 Vamvakas E.C Moore S.B Cabanela M Blood transfusion and septic complications after hip replacement surgery. Transfusion. 1995; 35: 150-156 Crossref PubMed Scopus (53) Google Scholar , 4 Tartter P.I Blood transfusion and infectious complications following colorectal cancer surgery. Br J Surg. 1988; 75: 789-792 Crossref PubMed Scopus (189) Google Scholar , 5 Blumberg N Heal J.M Immunomodulation by blood transfusion: an evolving scientific and clinical challenge. Am J Med. 1996; 101: 299-308 Abstract Full Text PDF PubMed Scopus (175) Google Scholar , 6 Blajchman M.A Dzik S Vamvakas E.C Sweeney J Snyder E.L Clinical and molecular basis of transfusion-induced immunomodulation: summary of the proceedings of a state-of-the-art conference. Transfus Med Rev. 2001; 15: 108-135 Abstract Full Text PDF PubMed Scopus (56) Google Scholar , 7 Agarwal N Murphy J.G Cayten C.G Stahl W.M Blood transfusion increases the risk of infection after trauma. Arch Surg. 1993; 128 (discussion 176–7): 171-176 Crossref PubMed Scopus (157) Google Scholar ], and the ever increasing consumption of blood products by a growing critical care population. Additionally, studies on the pathogenesis and treatment of septic shock have shown conflicting data on the benefits of augmenting oxygen delivery with allogeneic PRBCs [ 8 Blumberg N Heal J.M Mortality risks, costs, and decision making in transfusion medicine. Am J Clin Pathol. 2000; 114: 934-937 Crossref PubMed Scopus (21) Google Scholar , 9 Fitzgerald R.D Martin C.M Dietz G.E Doig G.S Potter R.F Sibbald W.J Transfusing red blood cells stored in citrate phosphate dextrose adenine-1 for 28 days fails to improve tissue oxygenation in rats. Crit Care Med. 1997; 25: 726-732 Crossref PubMed Scopus (186) Google Scholar , 10 Lorente J.A Landin L De Pablo R Renes E Rodriguez-Diaz R Liste D Effects of blood transfusion on oxygen transport variables in severe sepsis. Crit Care Med. 1993; 21: 1312-1318 Crossref PubMed Scopus (121) Google Scholar , 11 Marik P.E Sibbald W.J Effect of stored-blood transfusion on oxygen delivery in patients with sepsis. JAMA. 1993; 269: 3024-3029 Crossref PubMed Scopus (670) Google Scholar , 12 Shah D.M Gottlieb M.E Rahm R.L Stratton H.H Barie P.S Paloski W.H et al. Failure of red blood cell transfusion to increase oxygen transport or mixed venous PO2 in injured patients. J Trauma. 1982; 22: 741-746 Crossref PubMed Scopus (81) Google Scholar ]. In the last several years, many important studies have been published that not only cast doubt on the benefits of PRBC transfusion but also have sought to redefine the optimal threshold value of hemoglobin (HGB) concentration that warrants transfusion. Recently, there have been two large descriptive studies that sought to describe the current practice of PRBC transfusion in intensive care units (ICUs) and correlate that information with clinical outcomes. This article reviews these studies of current transfusion practices and tries to use this information as a guide to effective transfusion practice." @default.
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• W2127116176 date "2004-04-01" @default.
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• W2127116176 title "Blood transfusion practice today" @default.
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