The Impact of Erythrocyte Suspension Transfusion on Clinical Outcomes in Critical Care Settings

Yıl 2019, Cilt: 6 Sayı: 3, 123 - 128, 31.12.2019

Gürhan Taşkın , Ramazan Öcal

Öz

In this study,
potential risks related to erythrocyte suspension (ES) transfusion in intensive
care patients and the impacts on clinical results of the transfusion are aimed
to be investigated. 259 patients who were hospitalized for more than 24 hours
in intensive care unit (ICU) were included in the study. Demographic findings
related to the patients, APACHE II scores, length of ICU stay, overall ICU
mortality, culture results, causes of anemia in patients who are applied transfusion
and levels of Hemoglobin (Hgb) and Hematocrit (Hct) with Hgb and Hct levels of
post-transfusion and  complications
related to transfusion were recorded. Of the 259 cases included in the study,
78 (30.1%) were received transfusion and the mean Hgb threshold for transfusion
was 7.35±1.00 gr/dL. In the transfusion group; chronic renal failure (p=0.007)
and sepsis (p=0.001) were found significantly frequent and APACHE II score was
higher (p=0.001). ICU length of stay (23.84±21.89 vs. 12.70±9.68) was also significantly
longer in the transfusion group (p<0.001). Nosocomial pathogen-related
infections were also significantly more frequent in the transfusion group
(28.2%, p=0.043). Transfusion itself had a close relationship with mortality
(37.2% vs. 22.7%, p=0.016). Mortality rates were found to be significantly
higher in patients with transfusion-related complications (p=0.048),
concomitant malignancy (p=0.020) and nasocomial pathogen-related infections
(p=0.048). In addition to ES transfusion that is life saving, patients’ needs
should be carefully assessed considering its potential risks. Strategy of
restrictive transfusion that has lower mortality rates is one of the most
attention grabbing results.

Anahtar Kelimeler

Erythrocyte Suspension, Hemoglobin, Intensive Care, Mortality, Transfusion

Yoğun Bakımda Eritrosit Transfüzyonunun Klinik Sonlanımlar Üzerine Etkisi

Öz

Bu araştırma ile yoğun bakım hastalarında
eritrosit süspansiyonu (ES) transfüzyona ait potansiyel riskler ve
transfüzyonun klinik sonuçlar üzerine etkilerinin araştırılması amaçlanmıştır.
Yoğun Bakım Ünitesinde (YBÜ) 24 saatten uzun süre yatarak tedavi gören 259
hasta araştırmaya dâhil edilmiştir. Bu hastalara ait demografik veriler, APACHE
II skorları, yoğun bakım yatış süreleri, mortalite, kültür üreme sonuçları,
transfüzyon uygulanan hastaların anemi nedenleri ve Hemoglobin (Hgb) ve
Hematokrit (Hct) düzeyleri ile transfüzyon sonrası Hgb ve Hct düzeyleri ve transfüzyona
ait komplikasyonlar değerlendirildi. Araştırmaya dahil edilen 259 olgudan 78
(%30.1)’ne transfüzyon yapıldığı ve ortalama transfüzyon eşik hemoglobin
değerinin 7.35±1.00 gr/dL olduğu saptandı. Transfüzyon grubunda kronik böbrek
yetmezliği (p=0.007), sepsis (p=0.001) anlamlı oranda sık ve APACHE II skoru
daha yüksek saptandı (p=0.001). YBÜ yatış süresi de transfüzyon grubunda
(23.84±21.89 karşın 9.68±12.70 gün) anlamlı derecede uzundu (p<0.001).
Nazokomiyal enfeksiyonlar transfüzyon grubunda %28.2 ile anlamlı derecede daha
sıktı (p=0.043). Diğer yandan transfüzyonunun kendisi de mortalite (%37.2
karşın %22.7, p=0.016) ile yakın ilişkiye sahipti. Transfüzyon ile ilişkili
komplikasyon izlenenlerde (p=0.048), eşlik eden malignite varlığında (p=0.020) ve
nazokomiyal enfeksiyon gelişenlerde (p=0.048) mortalite oranı anlamlı düzeyde
sık saptandı. ES transfüzyonunun hayat kurtarıcı olmasının yanı sıra potansiyel
risklerin göz önünde bulundurularak hastaların ihtiyaçlarının titizlikle
seçilmesi gerekmektedir. Kısıtlı transfüzyon stratejisinin daha düşük mortalite
oranlarına sahip olması ise en dikkat çekici sonuçlarımızdan biridir.

Anahtar Kelimeler

Eritrosit Süspansiyonu, Hemoglobin, Mortalite, Transfüzyon, Yoğun Bakım

Kaynakça

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