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ISSN: 1642-5758
Anaesthesiology Intensive Therapy
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5/2021
vol. 53
 
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abstract:
Original paper

Effects of red blood cell transfusions given to non-septic critically ill patients: a propensity score matched study

Thomas Kander
1, 2
,
Caroline U. Nilsson
1, 2
,
Daniel Larsson
1
,
Peter Bentzer
1, 3

1.
Department of Clinical Sciences, Medical Faculty, Lund University, Lund, Sweden
2.
Department of Intensive and Perioperative Care, Skåne University Hospital, Lund, Sweden
3.
Department of Anaesthesia and Intensive Care, Helsingborg lasarett, Sweden
Anaesthesiol Intensive Ther 2021; 53, 5: 390–397
Online publish date: 2021/12/30
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Introduction
Previous studies have demonstrated that low-grade red blood cell transfusions (RBC) given to septic patients are harmful. The objectives of the present study were to compare mortality and morbidity in non-septic critically ill patients who were given low-grade RBC transfusions at haemoglobin level > 70 γ L–1 with patients without RBC-transfusions any of the first 5 days in intensive care.

Material and methods
Adult patients admitted to a general intensive care unit between 2007 and 2018 at a university hospital were eligible for inclusion. Patients who received > 2 units RBC transfusion per day during the first 5 days after admisasion, with pre-transfusion haemoglobin level < 70 γ L–1 or with severe sepsis or septic shock, were excluded.

Results
In total, 9491 admissions were recorded during the study period. Propensity score matching resulted in 2 well matched groups with 674 unique patients in each. Median pre-transfusion haemoglobin was 98 γ L–1 (interquartile range 91–107 γ L–1). Mortality was higher in the RBC group with an absolute risk increase for death at 180 days of 5.9% (95% CI: 3.6–8.3; P < 0.001). Low-grade RBC-transfusion was also associated with renal, circulatory, and respiratory failure as well as a higher SOFA-max score. Sensitivity analyses suggested that disease trajectories during the exposure time did not significantly differ between the groups.

Conclusions
Low-grade RBC-transfusions given to non-septic critically ill patients without significant anaemia were associated with increased mortality, increased kidney, circulatory, and respiratory failure, as well as higher SOFA-max score.

keywords:

blood transfusion, renal failure, respiratory failure, mortality, circulatory failure, days alive and free, erythrocyte transfusion

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