Physiologic transfusion triggers.
In clinical practice, the decision to transfuse is linked to the hope of increasing oxygen transport (TO2) to tissues. Physiologic transfusion triggers should progressively replace arbitrary hemoglobin-based transfusion triggers. These 'physiologic' transfusion triggers can be based on signs and symptoms of impaired global oxygenation (lactate, venous O2 saturation [SvO2]) or, even better, of regional tissue oxygenation (electrocardiographic ST-segment, electroencephalographic P300 latency). The SvO2 or its surrogate, the central venous 02 saturation (ScvO2), is a clinical tool which integrates the relationship between whole-body O2 uptake and TO2, and as such can be proposed as a simple physiologic transfusion trigger.
Vallet
Benoit
B
Department of Anesthesiology and Intensive Care Medicine, University Hospital of Lille, France. bvallet@chru-lille.fr
Adamczyk
Sébastien
S
Barreau
Olivier
O
Lebuffe
Gilles
G
D001803:Blood Transfusion; D002405:Catheterization, Central Venous; D002985:Clinical Protocols; D016638:Critical Illness / Q000145:classification / Q000628:therapy; D003657:Decision Making; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008991:Monitoring, Physiologic / Q000379:methods; D010092:Oximetry; D010100:Oxygen / Q000097:blood*; D010101:Oxygen Consumption; D012016:Reference Values; D012151:Resuscitation; D065227:Transfusion Reaction; D014680:Veins
D006454:Hemoglobins; D010100:Oxygen