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Báo cáo y học: "ICU Cornerstone: Changing our view of blood transfusions"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: ICU Cornerstone: Changing our view of blood transfusions. | Available online http ccforum.eom content 6 4 291 Commentary ICU Cornerstone Changing our view of blood transfusions Warren L Lee1 and Gregory P Downey2 1 Fellow InterDepartmental Division of Critical Care Medicine and the Division of Respirology University of Toronto Ontario Canada 2Director Division of Respirology University of Toronto Consultant Respirologist Toronto General Hospital of the University Health Network the Department of Medicine Toronto Ontario Canada Correspondence Gregory P Downey gregory.downey@utoronto.ca Published online 24 May 2002 Critical Care 2002 6 291-292 This article is online at http ccforum.com content 6 4 291 2002 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Abstract Blood transfusions are commonly administered to critically ill patients but deciding when to transfuse a particular patient is often difficult and necessitates careful consideration of both the potential benefits and risks. This commentary briefly discusses some of the considerations both for and against blood transfusion in the setting of critical illness and reviews a landmark clinical trial in this area. Finally we reflect on the changes in attitudes towards the transfusion of blood and blood products that have taken place over the last 20 years. Keywords anemia blood transfusion critical care hepatitis HIV Blood transfusions have long been a common component of the therapy of critically ill patients yet knowing when a particular patient will benefit from a transfusion has not always been clear 1 . Until recently the optimal hemoglobin concentration in critically ill patients was empirically set at 10 g dl and most patients in critical care units received transfusions during their stay in the unit 2 3 . There was no evidence from clinical trials to support this practice but some studies had demonstrated a pathologic dependence of oxygen consumption Vo2 on oxygen delivery Do2 in conditions like sepsis and acute respiratory distress syndrome 4 . These .