Open AccessAnemia in the Intensive Care Unit: How Big Is the Problem?
Author(s) -
Gattii Luciano,
Chiumello Davide
Publication year - 2002
Publication title -
transfusion alternatives in transfusion medicine
Language(s) - English
Resource type - Journals
eISSN - 1778-428X
pISSN - 1295-9022
DOI - 10.1111/j.1778-428x.2002.tb00072.x
Subject(s) - medicine , phlebotomy , anemia , intensive care medicine , intensive care unit , hemoglobin , oxygen delivery , clinical practice , blood loss , oxygenation , critically ill , surgery , anesthesia , oxygen , nursing , chemistry , organic chemistry
SUMMARY Anemia is a common problem in critically ill patients. After three days in the intensive care unit, over 90% of patients present with anemia. Blood loss through phlebotomy appears to be an important cause of anemia in this setting. Lower hemoglobin concentrations are associated with an increased hospital length of stay and higher mortality. In clinical practice, red blood cell (RBC) transfusions are administered in order to increase the arterial oxygen content and the oxygen delivery so as to preserve tissue oxygenation. However, it is still not clear if RBC transfusions increase oxygen consumption, i.e. improve tissue oxygenation. Based on available data and clinical practice guidelines, the decision to transfuse RBCs should be based not only on a hemoglobin trigger but on the clinical status of the individual patient. Despite available guidelines, the economic impact of inappropriate RBC transfusions has been shown to account for up to 24% of the total cost of all blood component transfused.