tailieunhanh - Báo cáo y học: " Debate: Transfusing to normal haemoglobin levels will not improve outcome"

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: Debate: Transfusing to normal haemoglobin levels will not improve outcome. | Available online http content 5 2 056 Commentary Debate Transfusing to normal haemoglobin levels will not improve outcome Gonzalo Alvarez Paul C Hébert and Sharyn Szick Department of Medicine Ottawa Hospital Ottawa Ontario Canada Correspondence Paul C Hébert MD FRCPC MHSc Epid Department of Medicine Ottawa Hospital General Campus 501 Smyth Road Box 201 Ottawa Ontario K1H 8L6 Canada Received 24 January 2001 Accepted 21 February 2001 Published 8 March 2001 Critical Care 2001 5 56-63 2001 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Abstract Recent evidence suggests that critically ill patients are able to tolerate lower levels of haemoglobin than was previously believed. It is our goal to show that transfusing to a level of 100 g l does not improve mortality and other clinically important outcomes in a critical care setting. Although many questions remain many laboratory and clinical studies including a recent randomized controlled trial RCT have established that transfusing to normal haemoglobin concentrations does not improve organ failure and mortality in the critically ill patient. In addition a restrictive transfusion strategy will reduce exposure to allogeneic transfusions result in more efficient use of red blood cells RBCs save blood overall and decrease health care costs. Keywords anemia hemoglobin concentration red blood cells transfusion transfusion strategies Introduction Anaemia is a common condition in critically ill patients and RBC transfusions are often used in the treatment and management of this patient population. In fact one study 1 reported that 25 of all critically ill patients received RBC transfusions. Many laboratory studies 2-8 have examined the physiological responses ie compensatory mechanisms of the body to anaemia which include the following 9 increased cardiac output decreased blood viscosity capillary changes increased oxygen extraction and other tissue adaptations to meet oxygen requirements. Although .