Journal of Critical and Intensive Care 2022 , Vol 13, Issue 2
Anemia and Red Blood Cell Transfusion Practices in a Medical Intensive Care Unit
Turkay AKBAS 1 ,Oner Abidin BALBAY 2
1University of Düzce School of Medicine , Internal Medicine Department, Section of Intensive Care Unit, Düzce, Turkey
2University of Düzce School of Medicine, Pulmonary and Critical Care Medicine, Düzce, Turkey
DOI : 10.37678/dcybd.2022.3111 Objective: The study was aimed to describe red blood cell (RBC) transfusion practices in a medical intensive care unit (ICU).

Material and Method: This retrospective study involved patients admitted to the ICU between September 2015 and February 2020. A restrictive transfusion strategy was applied during the study period, in which hemoglobin levels were kept between 7.0 and 9.0 g/dL, and the recommended threshold for RBC transfusion was <7 g/dL, except for patients with acute coronary disease, acute cerebrovascular event, heart failure, severe hypoxemia, or undergoing hip fracture surgery, for whom hemoglobin levels were kept at ≥8 g/dL.

Results: Six hundred seventeen patients were included in the study (age 70±16 years, 51.7% male), with a mean hemoglobin level of 11.1±2.3 g/dL on admission. RBC transfusion was performed on 204 (33.1%) patients, and admission hemoglobin levels were significantly lower in the transfused than the non-transfused patients (9.4±1.9 vs. 11.9±2.1 g/dL; p<0.001). An average of 3.5 units per patient was transfused. Transfused patients had high disease severity scores, required high rates of invasive mechanical ventilation, renal replacement therapy and vasopressor use, and had longer ICU and hospital stays. ICU, in-hospital, 28-day, and 90-day mortality rates were significantly high among transfused patients. Logistic regression analysis identified RBC transfusion as an important predictor of 28-day (OR, 2.51; 95% CI, 1.49-4.23, p=0.001) and 90-day (OR, 1.69; 95% CI, 1.25-2.28; p=0.001) mortality.

Conclusion: Patients receiving RBC transfusion have high disease severity scores, exhibit low admission hemoglobin levels, require more organ support therapies, and have high mortality rates. The presence of RBC transfusion is a significant predictor of mortality. Keywords : Critical illness, anemia, blood transfusion, mortality