A Canadian survey of transfusion practices in critically ill patients
OBJECTIVESTo characterize the contemporary red cell transfusion practice in the critically ill and to define clinical factors that influence these practices. DESIGNScenario-based national survey. STUDY POPULATIONCanadian critical care practitioners. MEASUREMENTS AND MAIN RESULTSWe evaluated transfus...
Gespeichert in:
Veröffentlicht in: | Critical care medicine 1998-03, Vol.26 (3), p.482-487 |
---|---|
Hauptverfasser: | , , , , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 487 |
---|---|
container_issue | 3 |
container_start_page | 482 |
container_title | Critical care medicine |
container_volume | 26 |
creator | Hebert, Paul C Wells, George Martin, Claudio Tweeddale, Martin Marshall, John Blajchman, Morris Pagliarello, Giuseppe Schweitzer, Irwin Calder, Lisa |
description | OBJECTIVESTo characterize the contemporary red cell transfusion practice in the critically ill and to define clinical factors that influence these practices.
DESIGNScenario-based national survey.
STUDY POPULATIONCanadian critical care practitioners.
MEASUREMENTS AND MAIN RESULTSWe evaluated transfusion thresholds before transfusion and the number of red cell units ordered, under the given conditions.Of 254 Canadian critical care physicians, 193 (76%) responded to the survey.The primary specialty of most respondents was internal medicine (56%). Internal medicine respondents were in practice for an average of 8.4 +/- 5.7 (SD) yrs, and worked most often in combined medical/surgical intensive care units. Baseline hemoglobin transfusion thresholds averaged from 8.3 +/- 1.0 g/dL in a scenario involving a young stable trauma victim to 9.5 +/- 1.0 g/dL for an older patient after gastrointestinal bleeding. Transfusion thresholds differed significantly (p < .0001) between all four separate scenarios. With the exception of congestive heart failure (p > .05), all clinical factors (including age, Acute Physiology and Chronic health Evaluation II score, preoperative status, hypoxemia, shock, lactic acidosis, coronary ischemia, and chronic anemia) significantly (p< .0001) modified the transfusion thresholds. A statistically significant (p< .01) difference in baseline transfusion thresholds was noted across four major regions (with a maximum of five academic centers per region) of the country. Low physician numbers in two of the regions did not allow for further investigation of regional variations.
CONCLUSIONSThere is significant variation in critical care transfusion practice, with many intensivists adhering to a 10.0-g/dL threshold, while other physicians described a much more restrictive approach to red cell transfusion. Also, many physicians opted to administer multiple units, despite published guidelines to the contrary. Additionally, the administration of red cells was strongly influenced by a number of clinical factors, many unique to intensive care unit patients. There is a need for prospective studies to define optimal practice in the critically ill. (Crit Care Med 1998; 26:482-487) |
doi_str_mv | 10.1097/00003246-199803000-00019 |
format | Article |
fullrecord | <record><control><sourceid>wolterskluwer_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1097_00003246_199803000_00019</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>00003246-199803000-00019</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3319-7edb75fe6dc5f714dd466f1b461cce638d5ce997600f1baf0f06ae8c33ebebe73</originalsourceid><addsrcrecordid>eNp1kEFPAyEQhYnRxFr9Dxy8rkJhYTk2TdUmTbzomUzZIUVxdwNbm_570WpvDpkMQ94jeR8hlLM7zoy-Z6XETKqKG9MwUbaqNDdnZMJrUZaZEedkwphhlZBGXJKrnN-KQtZaTMhyThfQQRugo3mXPvFAe0_HBF32uxz6jg4J3BgcZho66lIod4jxQEOMdIAxYDfma3LhIWa8-Z1T8vqwfFk8Vevnx9Vivq6cENxUGtuNrj2q1tVec9m2UinPN1Jx51CJpq0dGqMVY-UVPPNMATbFjJtytJiS5vivS33OCb0dUviAdLCc2W8c9g-HPeGwPziK9fZoHSCXAL4kdCGf_DPeCNXwIpNH2b6PI6b8Hnd7THaLEMet_Q-2-AK6K3BZ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>A Canadian survey of transfusion practices in critically ill patients</title><source>Journals@Ovid Complete</source><creator>Hebert, Paul C ; Wells, George ; Martin, Claudio ; Tweeddale, Martin ; Marshall, John ; Blajchman, Morris ; Pagliarello, Giuseppe ; Schweitzer, Irwin ; Calder, Lisa</creator><creatorcontrib>Hebert, Paul C ; Wells, George ; Martin, Claudio ; Tweeddale, Martin ; Marshall, John ; Blajchman, Morris ; Pagliarello, Giuseppe ; Schweitzer, Irwin ; Calder, Lisa</creatorcontrib><description>OBJECTIVESTo characterize the contemporary red cell transfusion practice in the critically ill and to define clinical factors that influence these practices.
DESIGNScenario-based national survey.
STUDY POPULATIONCanadian critical care practitioners.
MEASUREMENTS AND MAIN RESULTSWe evaluated transfusion thresholds before transfusion and the number of red cell units ordered, under the given conditions.Of 254 Canadian critical care physicians, 193 (76%) responded to the survey.The primary specialty of most respondents was internal medicine (56%). Internal medicine respondents were in practice for an average of 8.4 +/- 5.7 (SD) yrs, and worked most often in combined medical/surgical intensive care units. Baseline hemoglobin transfusion thresholds averaged from 8.3 +/- 1.0 g/dL in a scenario involving a young stable trauma victim to 9.5 +/- 1.0 g/dL for an older patient after gastrointestinal bleeding. Transfusion thresholds differed significantly (p < .0001) between all four separate scenarios. With the exception of congestive heart failure (p > .05), all clinical factors (including age, Acute Physiology and Chronic health Evaluation II score, preoperative status, hypoxemia, shock, lactic acidosis, coronary ischemia, and chronic anemia) significantly (p< .0001) modified the transfusion thresholds. A statistically significant (p< .01) difference in baseline transfusion thresholds was noted across four major regions (with a maximum of five academic centers per region) of the country. Low physician numbers in two of the regions did not allow for further investigation of regional variations.
CONCLUSIONSThere is significant variation in critical care transfusion practice, with many intensivists adhering to a 10.0-g/dL threshold, while other physicians described a much more restrictive approach to red cell transfusion. Also, many physicians opted to administer multiple units, despite published guidelines to the contrary. Additionally, the administration of red cells was strongly influenced by a number of clinical factors, many unique to intensive care unit patients. There is a need for prospective studies to define optimal practice in the critically ill. (Crit Care Med 1998; 26:482-487)</description><identifier>ISSN: 0090-3493</identifier><identifier>EISSN: 1530-0293</identifier><identifier>DOI: 10.1097/00003246-199803000-00019</identifier><identifier>CODEN: CCMDC7</identifier><language>eng</language><publisher>Hagerstown, MD: Williams & Wilkins</publisher><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis ; Medical sciences ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy</subject><ispartof>Critical care medicine, 1998-03, Vol.26 (3), p.482-487</ispartof><rights>Williams & Wilkins 1998. All Rights Reserved.</rights><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3319-7edb75fe6dc5f714dd466f1b461cce638d5ce997600f1baf0f06ae8c33ebebe73</citedby><cites>FETCH-LOGICAL-c3319-7edb75fe6dc5f714dd466f1b461cce638d5ce997600f1baf0f06ae8c33ebebe73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2183681$$DView record in Pascal Francis$$Hfree_for_read</backlink></links><search><creatorcontrib>Hebert, Paul C</creatorcontrib><creatorcontrib>Wells, George</creatorcontrib><creatorcontrib>Martin, Claudio</creatorcontrib><creatorcontrib>Tweeddale, Martin</creatorcontrib><creatorcontrib>Marshall, John</creatorcontrib><creatorcontrib>Blajchman, Morris</creatorcontrib><creatorcontrib>Pagliarello, Giuseppe</creatorcontrib><creatorcontrib>Schweitzer, Irwin</creatorcontrib><creatorcontrib>Calder, Lisa</creatorcontrib><title>A Canadian survey of transfusion practices in critically ill patients</title><title>Critical care medicine</title><description>OBJECTIVESTo characterize the contemporary red cell transfusion practice in the critically ill and to define clinical factors that influence these practices.
DESIGNScenario-based national survey.
STUDY POPULATIONCanadian critical care practitioners.
MEASUREMENTS AND MAIN RESULTSWe evaluated transfusion thresholds before transfusion and the number of red cell units ordered, under the given conditions.Of 254 Canadian critical care physicians, 193 (76%) responded to the survey.The primary specialty of most respondents was internal medicine (56%). Internal medicine respondents were in practice for an average of 8.4 +/- 5.7 (SD) yrs, and worked most often in combined medical/surgical intensive care units. Baseline hemoglobin transfusion thresholds averaged from 8.3 +/- 1.0 g/dL in a scenario involving a young stable trauma victim to 9.5 +/- 1.0 g/dL for an older patient after gastrointestinal bleeding. Transfusion thresholds differed significantly (p < .0001) between all four separate scenarios. With the exception of congestive heart failure (p > .05), all clinical factors (including age, Acute Physiology and Chronic health Evaluation II score, preoperative status, hypoxemia, shock, lactic acidosis, coronary ischemia, and chronic anemia) significantly (p< .0001) modified the transfusion thresholds. A statistically significant (p< .01) difference in baseline transfusion thresholds was noted across four major regions (with a maximum of five academic centers per region) of the country. Low physician numbers in two of the regions did not allow for further investigation of regional variations.
CONCLUSIONSThere is significant variation in critical care transfusion practice, with many intensivists adhering to a 10.0-g/dL threshold, while other physicians described a much more restrictive approach to red cell transfusion. Also, many physicians opted to administer multiple units, despite published guidelines to the contrary. Additionally, the administration of red cells was strongly influenced by a number of clinical factors, many unique to intensive care unit patients. There is a need for prospective studies to define optimal practice in the critically ill. (Crit Care Med 1998; 26:482-487)</description><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis</subject><subject>Medical sciences</subject><subject>Transfusions. Complications. Transfusion reactions. Cell and gene therapy</subject><issn>0090-3493</issn><issn>1530-0293</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><recordid>eNp1kEFPAyEQhYnRxFr9Dxy8rkJhYTk2TdUmTbzomUzZIUVxdwNbm_570WpvDpkMQ94jeR8hlLM7zoy-Z6XETKqKG9MwUbaqNDdnZMJrUZaZEedkwphhlZBGXJKrnN-KQtZaTMhyThfQQRugo3mXPvFAe0_HBF32uxz6jg4J3BgcZho66lIod4jxQEOMdIAxYDfma3LhIWa8-Z1T8vqwfFk8Vevnx9Vivq6cENxUGtuNrj2q1tVec9m2UinPN1Jx51CJpq0dGqMVY-UVPPNMATbFjJtytJiS5vivS33OCb0dUviAdLCc2W8c9g-HPeGwPziK9fZoHSCXAL4kdCGf_DPeCNXwIpNH2b6PI6b8Hnd7THaLEMet_Q-2-AK6K3BZ</recordid><startdate>199803</startdate><enddate>199803</enddate><creator>Hebert, Paul C</creator><creator>Wells, George</creator><creator>Martin, Claudio</creator><creator>Tweeddale, Martin</creator><creator>Marshall, John</creator><creator>Blajchman, Morris</creator><creator>Pagliarello, Giuseppe</creator><creator>Schweitzer, Irwin</creator><creator>Calder, Lisa</creator><general>Williams & Wilkins</general><general>Lippincott</general><scope>IQODW</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>199803</creationdate><title>A Canadian survey of transfusion practices in critically ill patients</title><author>Hebert, Paul C ; Wells, George ; Martin, Claudio ; Tweeddale, Martin ; Marshall, John ; Blajchman, Morris ; Pagliarello, Giuseppe ; Schweitzer, Irwin ; Calder, Lisa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3319-7edb75fe6dc5f714dd466f1b461cce638d5ce997600f1baf0f06ae8c33ebebe73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis</topic><topic>Medical sciences</topic><topic>Transfusions. Complications. Transfusion reactions. Cell and gene therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hebert, Paul C</creatorcontrib><creatorcontrib>Wells, George</creatorcontrib><creatorcontrib>Martin, Claudio</creatorcontrib><creatorcontrib>Tweeddale, Martin</creatorcontrib><creatorcontrib>Marshall, John</creatorcontrib><creatorcontrib>Blajchman, Morris</creatorcontrib><creatorcontrib>Pagliarello, Giuseppe</creatorcontrib><creatorcontrib>Schweitzer, Irwin</creatorcontrib><creatorcontrib>Calder, Lisa</creatorcontrib><collection>Pascal-Francis</collection><collection>CrossRef</collection><jtitle>Critical care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hebert, Paul C</au><au>Wells, George</au><au>Martin, Claudio</au><au>Tweeddale, Martin</au><au>Marshall, John</au><au>Blajchman, Morris</au><au>Pagliarello, Giuseppe</au><au>Schweitzer, Irwin</au><au>Calder, Lisa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Canadian survey of transfusion practices in critically ill patients</atitle><jtitle>Critical care medicine</jtitle><date>1998-03</date><risdate>1998</risdate><volume>26</volume><issue>3</issue><spage>482</spage><epage>487</epage><pages>482-487</pages><issn>0090-3493</issn><eissn>1530-0293</eissn><coden>CCMDC7</coden><abstract>OBJECTIVESTo characterize the contemporary red cell transfusion practice in the critically ill and to define clinical factors that influence these practices.
DESIGNScenario-based national survey.
STUDY POPULATIONCanadian critical care practitioners.
MEASUREMENTS AND MAIN RESULTSWe evaluated transfusion thresholds before transfusion and the number of red cell units ordered, under the given conditions.Of 254 Canadian critical care physicians, 193 (76%) responded to the survey.The primary specialty of most respondents was internal medicine (56%). Internal medicine respondents were in practice for an average of 8.4 +/- 5.7 (SD) yrs, and worked most often in combined medical/surgical intensive care units. Baseline hemoglobin transfusion thresholds averaged from 8.3 +/- 1.0 g/dL in a scenario involving a young stable trauma victim to 9.5 +/- 1.0 g/dL for an older patient after gastrointestinal bleeding. Transfusion thresholds differed significantly (p < .0001) between all four separate scenarios. With the exception of congestive heart failure (p > .05), all clinical factors (including age, Acute Physiology and Chronic health Evaluation II score, preoperative status, hypoxemia, shock, lactic acidosis, coronary ischemia, and chronic anemia) significantly (p< .0001) modified the transfusion thresholds. A statistically significant (p< .01) difference in baseline transfusion thresholds was noted across four major regions (with a maximum of five academic centers per region) of the country. Low physician numbers in two of the regions did not allow for further investigation of regional variations.
CONCLUSIONSThere is significant variation in critical care transfusion practice, with many intensivists adhering to a 10.0-g/dL threshold, while other physicians described a much more restrictive approach to red cell transfusion. Also, many physicians opted to administer multiple units, despite published guidelines to the contrary. Additionally, the administration of red cells was strongly influenced by a number of clinical factors, many unique to intensive care unit patients. There is a need for prospective studies to define optimal practice in the critically ill. (Crit Care Med 1998; 26:482-487)</abstract><cop>Hagerstown, MD</cop><pub>Williams & Wilkins</pub><doi>10.1097/00003246-199803000-00019</doi><tpages>6</tpages></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0090-3493 |
ispartof | Critical care medicine, 1998-03, Vol.26 (3), p.482-487 |
issn | 0090-3493 1530-0293 |
language | eng |
recordid | cdi_crossref_primary_10_1097_00003246_199803000_00019 |
source | Journals@Ovid Complete |
subjects | Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis Medical sciences Transfusions. Complications. Transfusion reactions. Cell and gene therapy |
title | A Canadian survey of transfusion practices in critically ill patients |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T22%3A03%3A20IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-wolterskluwer_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20Canadian%20survey%20of%20transfusion%20practices%20in%20critically%20ill%20patients&rft.jtitle=Critical%20care%20medicine&rft.au=Hebert,%20Paul%20C&rft.date=1998-03&rft.volume=26&rft.issue=3&rft.spage=482&rft.epage=487&rft.pages=482-487&rft.issn=0090-3493&rft.eissn=1530-0293&rft.coden=CCMDC7&rft_id=info:doi/10.1097/00003246-199803000-00019&rft_dat=%3Cwolterskluwer_cross%3E00003246-199803000-00019%3C/wolterskluwer_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/&rfr_iscdi=true |