Transfusion in the intensive care unit.
OBJECTIVE
To summarize the incidences of anemia and blood transfusions in critically ill patients, assess their comparative risks and benefits, and briefly speculate on the possible effects of leukoreduction and blood storage on the need to reevaluate transfusion triggers.


METHODS
A review of the current literature was performed.


RESULTS
Anemia is common in intensive care unit patients and is associated with increased mortality. Some 20-53% of intensive care unit patients will receive a blood transfusion during their stay, and these have also been associated with worse outcomes. Leukoreduction may limit some of the infectious and immunomodulatory risks associated with blood transfusion.


CONCLUSIONS
Data on the risks and benefits of blood transfusion are conflicting, and with recent changes in blood transfusion practice, including the widespread introduction of leukoreduction, it is time to reevaluate our transfusion triggers.
Vincent
Jean-Louis
JL
Department of Intensive Care Medicine, Erasme Hospital, Free University of Brussels, Belgium.
Piagnerelli
Michael
M
D000740:Anemia / Q000453:epidemiology / Q000628:therapy*; D001803:Blood Transfusion / Q000379:methods*; D002986:Clinical Trials as Topic; D016638:Critical Illness; D006801:Humans; D007362:Intensive Care Units; D047589:Leukocyte Reduction Procedures; D065227:Transfusion Reaction