Blood conservation strategies to reduce the need for red blood cell transfusion in critically ill patients

CMAJ. Canadian Medical Association Journal

Volumn 178, Issue 1, 2008, Pages 49-57

  Tinmouth, Alan T ^a,b   McIntyre, Lauralynn A ^a,b   Fowler, Robert A ^c,d  

^a OTTAWA HOSPITAL RESEARCH INSTITUTE   (Canada)

^b UNIVERSITY OF OTTAWA   (Canada)

^c SUNNYBROOK RESEARCH INSTITUTE   (Canada)

^d UNIVERSITY OF TORONTO   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

AMINOCAPROIC ACID; APROTININ; BLOOD SUBSTITUTE; DESMOPRESSIN; FLUOROCARBON; HEMOGLOBIN; HEMOSTATIC AGENT; PERFLUOROOCTYL BROMIDE; PLACEBO; RECOMBINANT BLOOD CLOTTING FACTOR 7A; RECOMBINANT ERYTHROPOIETIN; TRANEXAMIC ACID;

ANEMIA; BLEEDING; BONE MARROW SUPPRESSION; BRAIN HEMORRHAGE; CLINICAL TRIAL; CRITICAL ILLNESS; CRITICALLY ILL PATIENT; DIAGNOSTIC TEST; DRUG MECHANISM; ERYTHROCYTE TRANSFUSION; GASTROINTESTINAL HEMORRHAGE; HEMODILUTION; HEMOGLOBIN BLOOD LEVEL; HEMOPHILIA A; HEMOSTASIS; HUMAN; INTENSIVE CARE UNIT; MORBIDITY; MORTALITY; PERIOPERATIVE COMPLICATION; REVIEW; RISK FACTOR; SURGICAL PATIENT; TREATMENT OUTCOME; UPPER GASTROINTESTINAL BLEEDING; VON WILLEBRAND DISEASE;

EID: 38349080774     PISSN: 08203946     EISSN: 14882329     Source Type: Journal    
DOI: 10.1503/cmaj.071298     Document Type: Review

References (76)

1. Corwin HL, Gettinger A, Pearl RG, et al. The CRIT Study: anemia and blood transfusion in the critically ill - current clinical practice in the United States. Crit Care Med 2004;32:39-52.
2. Vincent JL, Baron JF, Reinhart K, et al. Anemia and blood transfusion in critically ill patients. JAMA 2002;288:1499-507.
3. Blajchman MA, Klein HG. Looking back in anger: retrospection in the face of a paradigm shift. Transfus Med Rev 1997;11:1-5.
4. Tinmouth AT, Fergusson DA, Yee IC, et al; ABLE Investigators and Canadian Critical Care Trials Group. Clinical consequences of red cell storage in the critically ill. Transfusion 2006;46:2014-27.
5. Ronco JJ, Fenwick JC, Tweeddale MG. Does increasing oxygen delivery improve outcome in the critically ill? No. Crit Care Clin 1996;12:645-59.
6. Hébert PC, Hu LQ, Biro GP. Review of physiologic mechanisms in response to anemia. CMAJ 1997;156:S27-40.
7. Rixen D, Raum M, Bouillon B, et al. Base deficit development and its prognostic significance in posttrauma critical illness: an analysis by the trauma registry of the Deutsche Gesellschaft für Unfallchirurgie. Shock 2001;15:83-9.
8. Kleinman S, Chan P, Robillard P. Risks associated with transfusion of cellular blood components in canada. Transfus Med Rev 2003;17:120-62.
9. Popovsky MA, editor. Transfusion reactions. 2nd ed. Bethesda (MD): AABB Press; 2001.
10. Hébert PC, Wells G, Blajchman MA, et al. A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. Transfusion Requirements in Critical Care Investigators, Canadian Critical Care Trials Group. N Engl J Med 1999;340:409-17.
11. Chang H, Hall GA, Geerts WH, et al. Allogeneic red blood cell transfusion is an independent risk factor for the development of postoperative bacterial infection. Vox Sang 2000;78:13-8.
12. Vamvakas EC, Carven JH. Transfusion and postoperative pneumonia in coronary artery bypass graft surgery: effect of the length of storage of transfused red cells. Transfusion 1999;39:701-10.
13. Fergusson D, Khanna MP, Tinmouth A, et al. Transfusion of leukoreduced red blood cells may decrease postoperative infections: two meta-analyses of randomized controlled trials. Can J Anaesth 2004;51:417-24.
14. Hardy JF, de Moerloose P, Samama CM. The coagulopathy of massive transfusion. Vox Sang 2005;89:123-7.
15. Henry DA, Carless P, Moxey A, et al. Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion [review]. Cochrane Database Syst Rev 2007;(4):CD001886.
16. Mangano DT, Tudor IC, Dietzel C. The risk associated with aprotinin in cardiac surgery. N Engl J Med 2006;354:353-65.
17. FDA requests marketing suspension of Trasylol [press release]. Rockville (MD): US Food and Drug Administration; 2007 Nov 5. Available: www.fda.gov/bbs/topics/NEWS/2007/NEW01738.html (accessed 2007 Nov 13).
18. Henry DA, O'Connell DL. Effects of fibrinolytic inhibitors on mortality from upper gastrointestinal haemorrhage. BMJ 1989;298:1142-6.
19. Auer LM, Marth E, Heppner F, et al. Proteolytic enzyme activity in patients with severe head injury and the effect of a proteinase inhibitor. Acta Neurochir (Wien) 1979;49:207-17.
20. McMichan JC, Rosengarten DS, Philipp E. Prophylaxis of post-traumatic pulmonary insufficiency by protease-inhibitor therapy with aprotinin: a clinical study. Circ Shock 1982;9:107-16.
21. Coats T, Roberts I, Shakur H. Antifibrinolytic drugs for acute traumatic injury [review]. Cochrane Database Syst Rev 2004;(4):CD004896.
22. Protocol 05PRT/1: the CRASH-2 (Clinical Randomization of an Anti-fibrinolytic in Significant Haemorrhage) trial [Lancet protocol review]. Available: www.thelancet.com/journals/lancet/misc/protocol/05PRT-1 (accesed 2007 Oct 22).
23. Mannucci PM. Hemostatic drugs. N Engl J Med 1998;339:245-53.
24. Mannucci PM. Desmopressin (DDAVP) in the treatment of bleeding disorders: the first 20 years. Blood 1997;90:2515-21.
25. Grant MJ, Huether SE, Witte MK. Effect of red blood cell transfusion on oxygen consumption in the anemic pediatric patient. Pediatr Crit Care Med 2003;4:459-64.
26. Levi M, Peters M, Buller HR. Efficacy and safety of recombinant factor VIIa for treatment of severe bleeding: a systematic review. Crit Care Med 2005;33:883-90.
27. Boffard KD, Riou B, Warren B, et al. Recombinant factor VIIa as adjunctive therapy for bleeding control in severely injured trauma patients: two parallel randomized, placebo-controlled, double-blind clinical trials. J Trauma 2005;59:8-15.
28. Bosch J, Thabut D, Bendtsen F, et al. Recombinant factor VIIa for upper gastrointestinal bleeding in patients with cirrhosis: a randomized, double-blind trial. Gastroenterology 2004;127:1123-30.
29. Diprose P, Herbertson MJ, O'Shaughnessy D, et al. Activated recombinant factor VII after cardiopulmonary bypass reduces allogeneic transfusion in complex non-coronary cardiac surgery: randomized double-blind placebo-controlled pilot study. Br J Anaesth 2005;95:596-602.
30. Lodge JP, Jonas S, Oussoultzoglou E, et al. Recombinant coagulation factor VIIa in major liver resection: a randomized, placebo-controlled, double-blind clinical trial. Anesthesiology 2005;102:269-75.
31. Planinsic RM, van der Meer MJ, Testa G, et al. Safety and efficacy of a single bolus administration of recombinant factor VIIa in liver transplantation due to chronic liver disease. Liver Transpl 2005;11:895-900.
32. Mayer SA, Brun NC, Begtrup K, et al. Recombinant activated factor VII for acute intracerebral hemorrhage. N Engl J Med 2005;352:777-85.
33. Stanworth SJ, Birchall J, Doree CJ, et al. Recombinant factor VIIa for the prevention and treatment of bleeding in patients without haemophilia [review]. Cochrane Database Syst Rev 2007;(2):CD005011.
34. Phase 3 stroke trial shows that NovoSeven reduces bleeding in the brain, but does not improve long-term clinical outcomes. Bagsvaerd (Denmark): Novo Nordisk; 2007 Feb 26. Available: www.novonordisk.com/press/sea/sea.asp? NewsTypeGuid=&sShowNewsItemGUID=ocfc120c-f013-4ad6-9130- 55227465e3e8&sShowLanguageCode=en-GB (accessed 2007 Nov 22).
35. Goodnough LT, Lublin DM, Zhang L, et al. Transfusion medicine service policies for recombinant factor VIIa administration. Transfusion 2004;44:1325-31.
36. 2 carriers: status in 2005. Curr Pharm Des 2005;11:4099-114.
37. Moore FA, Moore EE, Sauaia A. Blood transfusion. An independent risk factor for postinjury multiple organ failure. Arch Surg 1997;132:620-4.
38. Lamy ML, Daily EK, Brichant JF, et al. Randomized trial of diaspirin cross-linked hemoglobin solution as an alternative to blood transfusion after cardiac surgery. The DCLHb Cardiac Surgery Trial Collaborative Group. Anesthesiology 2000;92:646-56.
39. Schubert A, Przybelski RJ, Eidt JF, et al. Diaspirin-crosslinked hemoglobin reduces blood transfusion in noncardiac surgery: a multicenter, randomized, controlled, double-blinded trial. Anesth Analg 2003;97:323-32.
40. Sloan EP, Koenigsberg M, Gens D, et al. Diaspirin cross-linked hemoglobin (DCLHb) in the treatment of severe traumatic hemorrhagic shock: a randomized controlled efficacy trial. JAMA 1999;282:1857-64.
41. Gould SA, Moore EE, Hoyt DB, et al. The first randomized trial of human polymerized hemoglobin as a blood substitute in acute trauma and emergent surgery. J Am Coll Surg 1998;187:113-20.
42. Johnson JL, Moore EE, Offner PJ, et al. Resuscitation of the injured patient with polymerized stroma-free hemoglobin does not produce systemic or pulmonary hypertension. Am J Surg 1998;176:612-7.
43. Northfield Laboratories reports results of pivotal phase III trauma study [press release]. Evanston (IL): Northfield Laboratories Inc.; 2007 May 23. Available: http://phx.corporate-ir.net/phoenix.zhtml?c=91374&p=irol- newsArticle&ID=1005951&highlight= (accessed 2007 Oct 22).
44. Jahr JS. A novel blood substitute: results of a pivotal trial in orthopoedic surgery patients. Crit Care Med 2001;29:S243.
45. Levy JH, Goodnough LT, Greilich PE, et al. Polymerized bovine hemoglobin solution as a replacement for allogeneic red blood cell transfusion after cardiac surgery: results of a randomized, double-blind trial. J Thorac Cardiovasc Surg 2002;124:35-42.
46. LaMuraglia GM, O'Hara PJ, Baker WH, et al. The reduction of the allogenic transfusion requirement in aortic surgery with a hemoglobin-based solution. J Vasc Surg 2000;31:299-308.
47. Tremblay LN, Rizoli SB, Brenneman FD. Advances in fluid resuscitation of hemorrhagic shock. Can J Surg 2001;44:172-9.
48. Jenkinson SG. Oxygen toxicity. New Horiz 1993;1:504-11.
49. Spahn DR, Waschke KF, Standi T, et al; European Perflubron Emulsion in Non-Cardiac Surgery Study Group. Use of perflubron emulsion to decrease allogeneic blood transfusion in high-blood-loss non-cardiac surgery: results of a European phase 3 study. Anesthesiology 2002;97:1338-49.
50. Goodnough LT, Brecher ME, Kanter MH, et al. Transfusion medicine. Second of two parts - blood conservation. N Engl J Med 1999;340:525-33.
51. Huet C, Salmi LR, Fergusson D, et al. A meta-analysis of the effectiveness of cell salvage to minimize perioperative allogeneic blood transfusion in cardiac and orthopedic surgery. International Study of Perioperative Transfusion (ISPOT) Investigators. Anesth Analg 1999;89:861-9.
52. Fowler RA, Berenson M. Blood conservation in the intensive care unit. Crit Care Med 2003;31:S715-20.
53. Smoller BR, Kruskall MS. Phlebotomy for diagnostic laboratory tests in adults. Pattern of use and effect on transfusion requirements. N Engl J Med 1986;314:1233-5.
54. Corwin HL, Parsonnet KC, Gettinger A. RBC transfusion in the ICU. Is there a reason? Chest 1995;108:767-71.
55. Zimmerman JE, Seneff MG, Sun X, et al. Evaluating laboratory usage in the intensive care unit: patient and institutional characteristics that influence frequency of blood sampling. Crit Care Med 1997;25:737-48.
56. Henry ML, Garner WL, Fabri PJ. Iatrogenic anemia. Am J Surg 1986;151:362-3.
57. Von Ahsen N, Muller C, Serke S, et al. Important role of nondiagnostic blood loss and blunted erythropoietic response in the anemia of medical intensive care patients. Crit Care Med 1999;27:2630-9.
58. Corwin HL. Blood conservation in the critically ill patient. Anesthesiol Clin North America 2005;23:363-72.
59. Arkin S, Blei F, Fetten J, et al. Human coagulation factor FVIIa (recombinant) in the management of limb-threatening bleeds unresponsive to alternative therapies: results from the NovoSeven emergency-use programme in patients with severe haemophilia or with acquired inhibitors. Blood Coagul Fibrinolysis 2000;11:255-9.
60. Smoller BR, Kruskall MS, Horowitz GL. Reducing adult phlebotomy blood loss with the use of pediatric-sized blood collection tubes. Am J Clin Pathol 1989;91:701-3.
61. Gleason E, Grossman S, Campbell C. Minimizing diagnostic blood loss in critically ill patients. Am J Crit Care 1992;1:85-90.
62. MacIsaac CM, Presneill JJ, Boyce CA, et al. The influence of a blood conserving device on anaemia in intensive care patients. Anaesth Intensive Care 2003;31:653-7.
63. Peruzzi WT, Parker MA, Lichtenthal PR, et al. A clinical evaluation of a blood conservation device in medical intensive care unit patients. Crit Care Med 1993;21:501-6.
64. Silver MJ, Li YH, Gragg LA, et al. Reduction of blood loss from diagnostic sampling in critically ill patients using a blood-conserving arterial line system. Chest 1993;104:1711-5.
65. Zarychanski R, Turgeon AF, McIntyre L, et al. Erythropoietin-receptor agonists in critically ill patients: a meta-analysis of randomized controlled trials. CMAJ 2007;177:725-34.
66. Corwin HL, Gettinger A, Fabian TC, et al. Efficacy and safety of epoetin alfa in critically ill patients. N Engl J Med 2007;357:965-76.
67. Lacroix J, Hébert PC, Hutchison JS, et al. Transfusion strategies for patients in pediatric intensive care units. N Engl J Med 2007;356:1609-19.
68. Kirpalani H, Whyte RK, Andersen C, et al. The Premature Infants in Need of Transfusion (PINT) study: a randomized, controlled trial of a restrictive (low) versus liberal (high) transfusion threshold for extremely low birth weight infants. J Pediatr 2006;149:301-7.
69. Wu WC, Rathore SS, Wang Y, et al. Blood transfusion in elderly patients with acute myocardial infarction. N Engl J Med 2001;345:1230-6.
70. Rao SV, Jollis JG, Harrington RA, et al. Relationship of blood transfusion and clinical outcomes in patients with acute coronary syndromes. JAMA 2004;292:1555-62.
71. Bell EF, Strauss RG, Widness JA, et al. Randomized trial of liberal versus restrictive guidelines for red blood cell transfusion in preterm infants. Pediatrics 2005;115:1685-91.
72. Hébert PC, Wells G, Tweeddale M, et al. Does transfusion practice affect mortality in critically ill patients? Transfusion Requirements in Critical Care (TRICC) Investigators and the Canadian Critical Care Trials Group. Am J Respir Crit Care Med 1997;155:1618-23.
73. Tinmouth A, MacDougall L, Fergusson D, et al. Reducing the amount of blood transfused: a systematic review of behavioral interventions to change physicians' transfusion practices. Arch Intern Med 2005;165:845-52.
74. Wilson K, MacDougall L, Fergusson D, et al. The effectiveness of interventions to reduce physician's levels of inappropriate transfusion: what can be learned from a systematic review of the literature. Transfusion 2002;42:1224-9.
75. Walsh TS, McArdle F, McLellan SA, et al. Does the storage time of transfused red blood cells influence regional or global indexes of tissue oxygenation in anemic critically ill patients? Crit Care Med 2004;32:364-71.
76. French CJ, Bellomo R, Finfer SR, et al. Appropriateness of red blood cell transfusion in Australasian intensive care practice. Med Aust 2002;177:548-51.