Please see Bibliography of References for a list of abstracts, manuscripts and posters.

Hemorrhage

Does red blood cell transfusion improve tissue oxygenation in critically ill patients?

Neves A, Ventura A, Boreli V, Zattar F, Creteur J, Vincent J. Int Care Med. 2008;34(Supp 1):S257. Abstract 1010.

Introduction: Red blood cell (RBC) transfusions are commonly used in critically ill patients. A number of factors that can determine oxygen availability to the cells may not be reliably assessed from global hemodynamic measures. Near infrared spectroscopy (NIRS) has been proposed to assess tissue metabolism and oxygenation. We proposed to study the effect of RBC transfusion on muscle tissue metabolism and oxygenation using the NIRS in hemodynamically stable critically ill patients.

Methods: Hemodynamically stable ICU patients with anemia requiring RBC transfusions were included. Thenar muscle oxygenation (StO₂) and tissue hemoglobin index (THI) were continuously measured using NIRS (InSpectra™ Model 325, Hutchinson Technology Inc, Hutchinson, MN) before, during and after upper limb ischemia induced by a rapid pneumatic cuff inflation around the upper arm. The rate of StO₂ desaturation during the arterial occlusion (desaturation rate; %/min) and the StO₂ reperfusion rate immediately after the arterial occlusion (reperfusion rate; %/sec) were calculated. These different NIRS variables were collected before and after RBC transfusion.

Results: We studied 11 septic (3 with and 8 without shock) and 20 non-septic (12 patients after major surgery and 8 medical patients). RBC transfusion increased hemoglobin concentrations in both groups. The NIRS variables were comparable in both groups before and after transfusions.

Table 1:

Conclusion: RBC transfusion does not influence muscle metabolism and oxygenation in hemodynamically stable anemic critically ill patients.