Outcome of Restrictive versus Liberal Blood Transfusion Strategies in Intensive Care Unit Admitted Patients

Abstract

nemia is a very common disease in critically ill patients. Approximately 29% of patients have lower than normal hemoglobin levels when admitted to an ICU, and about 95% develop anemia within 3 days of admission. In a prospective, observational study, The authors reported that hemoglobin concentrations typically declined by more than 0.5 g/dl/day during the first few days in the ICU. Beyond the third day, hemoglobin concentrations remained relatively constant in non-septic patients but continued to decrease in septic patients as well as in patients with high Acute Physiology and Chronic Health Evaluation (APACHE) II scores. Casuses of anemia in critically ill patients include: 1-Phlebotomy; refered as iatrogenic anemia and may contribute to more than 70 ml blood loss in 24 hours. 2-Active Bleeding; occures in 30% of critically ill patients due to surgical causes. 3-Decreased Red Blood Cell Production; critically ill patients have low concentrations of erythropoietin, blunted response to erythropoietin, inflammatory cytokines, immune mediated functional iron deficiency, and other nutritional deficiencies.