Epidemiología de la transfusión sanguínea en los Servicios de Medicina Intensiva en España: «Transfusion Day»

  1. Juarez-Vela, R. 5
  2. Serrano-Lázaro, A. 4
  3. Andrés-Esteban, E.M. 26
  4. Quintana-Diaz, M. 12
  5. Nanwani-Nanwani, K. 12
  6. Marcos-Neira, P. 3
  1. 1 Hospital Universitario La Paz
    info

    Hospital Universitario La Paz

    Madrid, España

    ROR https://ror.org/01s1q0w69

  2. 2 Grupo PBM, Instituto de Investigación-IdiPaz, Madrid, España
  3. 3 Servicio de Medicina Intensiva, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
  4. 4 Hospital Clinico Universitario de Valencia
    info

    Hospital Clinico Universitario de Valencia

    Valencia, España

    ROR https://ror.org/00hpnj894

  5. 5 Universidad de La Rioja
    info

    Universidad de La Rioja

    Logroño, España

    ROR https://ror.org/0553yr311

  6. 6 Universidad Rey Juan Carlos
    info

    Universidad Rey Juan Carlos

    Madrid, España

    ROR https://ror.org/01v5cv687

Show affiliations +
Journal:
Medicina Intensiva

ISSN: 0210-5691

Year of publication: 2020

Type: Article

DOI: 10.1016/J.MEDIN.2020.08.015 GOOGLE SCHOLAR

More publications in: Medicina Intensiva

Abstract

Objective To describe the transfusion practice in the ICUs in Spain, according to national and international recommendations (guidelines).DesignProspective, cross-sectional, multi-centre study.ScopeData collection was carried out by means of a questionnaire sent electronically to the Heads of Service of 111 ICUs in Spain.Participants1,448 patients were included, aged 61.8 (SD 15.7) years, 66.2% male, with an SOFA of 4.7 ± 3.8 and average stay of 10.62 ± 17.49 days.VariablesDemographic and clinical variables of the patients were collected, as well as variables related to the transfusion act.ResultsOf the 1,448 patients, 9.9% received al least one transfusion of any blood product, 3.7% fresh plasma, 3.9% platelets and 8.9% red blood cell concentrate, mainly by analytical criteria (36.2%). Hemoglobin had a mean of 7.8 g/dL (95% CI: 6-9-8.5) and 9.8 g/dL (95% CI: 8.5-11.2) before and after the transfusion, respectively, p < 0.001. The transfusion units had a mean of 2.5 ± 2.4 per patient. The most commonly used blood product was red blood cell concentrate (90.2%). Patients admitted for surgery had a higher transfusion rate (14.4%) than those admitted for medical pathology (8.9%) (p = 0.006). 5.4% (7/129) of patients who received red blood cell concentrate died compared to 2.4% (31/1302) who did not (p = 0.04). Mortality of transfused patients was higher. The transfusion rate in most of hospitals was 5% to 20%, with 18 hospitals (16.21%) having transfusion rates between 20% and 50%. Hospitals with PBM programs and mass transfusion programs had a lower transfusion rate, although not statistically significant.ConclusionsIn this multicenter cross-sectional study, a transfusion prevalence of 9.9% was observed in Spanish critical care units. The most frequent blood product transfused was red blood cells and the main reasons for transfusion were acute anemia with hemodynamic impact and analytical criteria. Mortality of transfused patients was higher.

Bibliographic References

  • Marik, (2008), Crit Care Med., 36, pp. 2667, 10.1097/CCM.0b013e3181844677
  • Anthes, (2015), Nature., 520, pp. 24, 10.1038/520024a
  • Rogers, (2016), Vox Sang., 110, pp. 266, 10.1111/vox.12367
  • World Health Organization [who.int]. [Actualizado 18 Oct 2019]. Disponible en: http://www.who.int/bloodsafety/clinical_use/en/
  • Casans, (2015), Rev Esp Anestesiol Reanim., 62, pp. 61, 10.1016/j.redar.2014.12.005
  • Ministerio de Sanidad, Consumo y Bienestar Social [www.msssi.gob.es]. [Actualizado 1 Oct 2019]. Disponible en: http://www.msssi.gob.es/organizacion/sns/planCalidadSNS/cal_sscc.htm
  • Agencia Estatal Boletín Oficial del Estado [www.boe.es]. [Actualizado el 18 Oct 2019]. Disponible en: https://www.boe.es/eli/es/rd/2005/09/16/1088
  • Lauren, (2019), Transfusion medicine., 29, pp. 41, 10.1111/tme.12568
  • Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC). Grupo de Trabajo. [Consultado 6 May 2020]. Disponible en: https://semicyuc.org/wp-content/uploads/2018/08/50x70cm no hacer todos grupos-03 0.pdf
  • Leal-Novala, (2013), Med Intensiva., 37, pp. 259, 10.1016/j.medin.2012.12.013
  • Quintana-Díaz, (2020), Rev Clin Esp., 220, pp. 393, 10.1016/j.rce.2019.10.002
  • Vincent JL, Jaschinski U, Wittebole X, Lefrant JY, Jakob S, et al. Worldwide audit of blood transfusión practice in critically ill patients. Crit Care. 2018; 22:102-111.
  • Von Ahsen, (1999), Crit Care Med., 27, pp. 2630, 10.1097/00003246-199912000-00005
  • Elliot, (2003), Crit Care., 7, pp. R35, 10.1186/cc2185
  • Edna, (1998), Dis Colon Rectum., 41, pp. 451, 10.1007/BF02235758
  • Leach, (2002), Thorax, 57, pp. 170, 10.1136/thorax.57.2.170
  • Shah, (1982), J Trauma, 22, pp. 741, 10.1097/00005373-198209000-00004
  • Lorente, (1993), Crit Care Med., 21, pp. 1312, 10.1097/00003246-199309000-00013
  • Dietrich, (1990), Crit Care Med., 18, pp. 940, 10.1097/00003246-199009000-00007
  • Fernandes, (2001), Crit Care., 5, pp. 362, 10.1186/cc1070
  • Chatterjee, (2013), JAMA Intern Med., 173, pp. 132, 10.1001/2013.jamainternmed.1001
  • Sirchia G., (1996), Transfusion, 36
  • Quintana Díaz, (2009), Med Intensiva., 33, pp. 8, 10.1016/S0210-5691(09)70301-8
  • Libro de indicadores de calidad del enfermo crítico. Sociedad Española de Medicina Intensiva Crítica y Unidades Coronarias (SEMICYUC) [actualizado 2017; consultado 25 Jul 2020]. Disponible en: https://semicyuc.org/wp-content/uploads/2018/10/indicadoresdecalidad2017_semicyuc_spa-1.pdf