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Titolo:
Red blood cell transfusion does not increase oxygen consumption in critically ill septic patients
Autore:
Fernandes, CJ; Akamine, N; De Marco, FVC; de Souza, JAM; Lagudis, S; Knobel, E;
Indirizzi:
Hosp Israelita Albert Einstein, Intens Care Unit, Sao Paulo, Brazil Hosp Israelita Albert Einstein Sao Paulo Brazil Unit, Sao Paulo, Brazil
Titolo Testata:
CRITICAL CARE
fascicolo: 6, volume: 5, anno: 2001,
pagine: 362 - 367
SICI:
1466-609X(2001)5:6<362:RBCTDN>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
ADULT RESPIRATORY-DISTRESS; GASTRIC INTRAMUCOSAL PH; DELIVERY; SEPSIS; DYSFUNCTION; VALIDATION; VARIABLES; ALBUMIN; THERAPY; TRAUMA;
Keywords:
albumin; blood transfusion; fluid therapy; oxygen consumption; septic patients;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
32
Recensione:
Indirizzi per estratti:
Indirizzo: Fernandes, CJ Hosp Israelita Albert Einstein, Intens Care Unit, Sao Paulo,Brazil Hosp Israelita Albert Einstein Sao Paulo Brazil o, Brazil
Citazione:
C.J. Fernandes et al., "Red blood cell transfusion does not increase oxygen consumption in critically ill septic patients", CRIT CARE, 5(6), 2001, pp. 362-367

Abstract

Background Red blood cell (RBC) transfusion is commonly used to increase oxygen transport in patients with sepsis. However it does not consistently increase oxygen uptake at either the whole-body level, as calculated by the Fick method, or within individual organs, as assessed by gastric intramucosal pH. Aim This study evaluates the hemodynamic and oxygen utilization effects ofhemoglobin infusion on critically ill septic patients. Methods Fifteen septic patients undergoing mechanical ventilation whose hemoglobin was <10 g% were eligible. Ten patients (APACHE II: 25.5 <plus/minus> 7.6) received an infusion of 1 unit of packed RBC over 1 h while sedatedand paralyzed. The remaining five control patients (APACHE II: 24.3 +/- 6.0) received a 5% albumin solution (500 ml) over 1 h. Hemodynamic data, gastric tonometry and calorimetry were obtained prior to and immediately after RBC transfusion or 5% albumin infusion. Results Transfusion of RBC was associated with an improvement in left ventricular systolic work index (38.6 +/- 12.6 to 41.1 +/- 13.0 g/min/m(2); P =0.04). In the control group there was no significant change in the left ventricular systolic work index (37.2 +/- 14.3 to 42.2 +/- 18.9 g/min/m(2)). An increase in pulmonary vascular resistance index (203 +/- 58 to 238 +/- 49 dyne/cm(5)/m(2); P = 0.04) was also observed, while no change was produced by colloid infusion (237 +/- 87.8 to 226.4 +/- 57.8 dyne/cm(5)/m(2)). Oxygen utilization did not increase either by Fick equation or by indirect calorimetry in either group. Gastric intramucosal pH increased only in the control group but did not reach statistical significance. Conclusion Hemoglobin increase does not improve either global or regional oxygen utilization in anemic septic patients. Furthermore, RBC transfusion may hamper right ventricular ejection by increasing the pulmonary vascular resistance index.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/03/20 alle ore 14:41:01