Document Detail


Transfusion of packed red blood cells is not associated with improved central venous oxygen saturation or organ function in patients with septic shock.
MedLine Citation:
PMID:  22445679     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The exact role of packed red blood cell (PRBC) transfusion in the setting of early resuscitation in septic shock is unknown.
STUDY OBJECTIVE: To evaluate whether PRBC transfusion is associated with improved central venous oxygen saturation (ScvO(2)) or organ function in patients with severe sepsis and septic shock receiving early goal-directed therapy (EGDT).
METHODS: Retrospective cohort study (n=93) of patients presenting with severe sepsis or septic shock treated with EGDT.
RESULTS: Thirty-four of 93 patients received at least one PRBC transfusion. The ScvO(2) goal>70% was achieved in 71.9% of the PRBC group and 66.1% of the no-PRBC group (p=0.30). There was no difference in the change in Sequential Organ Failure Assessment (SOFA) score within the first 24 h in the PRBC group vs. the no-PRBC group (8.6-8.3 vs. 5.8-5.6, p=0.85), time to achievement of central venous pressure>8 mm Hg (732 min vs. 465 min, p=0.14), or the use of norepinephrine to maintain mean arterial pressure>65 mm Hg (81.3% vs. 83.8%, p=0.77).
CONCLUSIONS: In this study, the transfusion of PRBC was not associated with improved cellular oxygenation, as demonstrated by a lack of improved achievement of ScvO(2)>70%. Also, the transfusion of PRBC was not associated with improved organ function or improved achievement of the other goals of EGDT. Further studies are needed to determine the impact of transfusion of PRBC within the context of early resuscitation of patients with septic shock.
Authors:
Brian M Fuller; Mithil Gajera; Christa Schorr; David Gerber; R Phillip Dellinger; Joseph Parrillo; Sergio Zanotti
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Publication Detail:
Type:  Journal Article     Date:  2012-03-24
Journal Detail:
Title:  The Journal of emergency medicine     Volume:  43     ISSN:  0736-4679     ISO Abbreviation:  J Emerg Med     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-08     Completed Date:  2013-04-15     Revised Date:  2013-10-17    
Medline Journal Info:
Nlm Unique ID:  8412174     Medline TA:  J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  593-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Affiliation:
Department of Anesthesiology, Division of Critical Care Medicine, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
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MeSH Terms
Descriptor/Qualifier:
Arterial Pressure
Central Venous Pressure
Erythrocyte Transfusion*
Female
Humans
Male
Middle Aged
Norepinephrine / therapeutic use
Organ Dysfunction Scores
Oxygen / blood*
Retrospective Studies
Shock, Septic / blood,  physiopathology*,  therapy*
Time Factors
Vasoconstrictor Agents / therapeutic use
Grant Support
ID/Acronym/Agency:
UL1 RR024992/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Vasoconstrictor Agents; 51-41-2/Norepinephrine; 7782-44-7/Oxygen
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