title: [Transfusion practices in brazilian Intensive Care Units (pelo FUNDO-AMIB)].
abstract: OBJECTIVE
  Anemia of critical illness is a multifactorial condition caused by blood loss, frequent phlebotomies and inadequate production of red blood cells (RBC). Controversy surrounds the most appropriate hemoglobin concentration "trigger" for transfusion of RBC. We aimed to evaluate transfusion practices in Brazilian ICUs.
  
  
  METHODS
  A prospective study throughout a 2-week period in 19 Brazilian ICUs. Hemoglobin (Hb) level, transfusion rate, organ dysfunction assessment and 28-day mortality were evaluated. Primary indication for transfusion and pretransfusion hemoglobin level were collected for each transfusion.
  
  
  RESULTS
  Two hundred thirty-one patients with an ICU length of stay longer than 48h were included. An Hb level lower than 10 g/dL was found in 33% on admission in the ICU. A total of 348 RBC units were transfused in 86 patients (36.5%). The mean pretransfusion hemoglobin level was 7.7 ± 1.1 g/dL. Transfused-patients had significantly higher SOFA score (7.9 ± 4.6 vs 5.6 ± 3.8, p < 0.05, respectively), days on mechanical ventilation (10.7 ± 8.2 vs 7.2 ± 6.4, p < 0.05) and days on vasoactive drugs (6.7 ± 6.4 vs 4.2 ± 4.0, p < 0.05) than non-transfused patients despite similar APACHE II scores (15.2 ± 8.1 vs 14.2 ± 8.1, NS). Transfused patients had higher mortality rate (43.5%) than non-transfused patients (36.3%) (RR 0.60-1.15, NS). Only one patient (0.28%) had febrile non-hemolytic transfusion and urticarial reactions.
  
  
  CONCLUSIONS
  Anemia is common in critically ill patients.It seems from the present study that transfusion practices in Brazil have had a more restrictive approach with a lower limit "transfusion trigger".
authors.affiliation: Faculdade de Medicina de São José do Rio Preto, SP.
authors.forename: Suzana Margareth
authors.initials: SM
authors.lastname: Lobo
authors.affiliation: HC de Porto Alegre, Departamento de Medicina Interna, UFRGS, RS, Brasil.
authors.forename: Silvia Rios
authors.initials: SR
authors.lastname: Vieira
authors.affiliation: CTI dos Hospitais Cardiotrauma Ipanema e São Lucas, UFRJ, RJ.
authors.forename: Marcos Freitas
authors.initials: MF
authors.lastname: Knibel
authors.affiliation: Universidade Estadual de Londrina.
authors.forename: Cintia Magalhães Carvalho
authors.initials: CM
authors.lastname: Grion
authors.affiliation: UTI Central do Complexo Hospitalar Santa Casa, HCPA, FAMED, UFRGS.
authors.forename: Gilberto
authors.initials: G
authors.lastname: Friedman
authors.affiliation: Faculdade de Medicina de Catanduva.
authors.forename: Jorge Luis
authors.initials: JL
authors.lastname: Valiatti
authors.affiliation: Setor de Terapia, Disciplina de Anestesiologia, Dor e Terapia Intensiva, Universidade Federal de São Paulo.
authors.forename: Flávia Ribeiro
authors.initials: FR
authors.lastname: Machado
authors.affiliation: Santa Casa de Misericórdia de São Paulo.
authors.forename: Paulo Antonio
authors.initials: PA
authors.lastname: Chiavone
authors.affiliation: AMIB.
authors.forename: Luis Eduardo Miranda
authors.initials: LE
authors.lastname: Paciência
authors.affiliation: AMIB.
authors.forename: Juarez de
authors.initials: Jd
authors.lastname: Paula
authors.affiliation: Departamento de Medicina, AMIB.
authors.forename: Sérgio Mussi
authors.initials: SM
authors.lastname: Guimarães
authors.affiliation: American College.
authors.forename: João Luiz Ferreira
authors.initials: JL
authors.lastname: Costa
authors.affiliation: Hospital Pró Cardíaco.
authors.forename: Rubens Carmo
authors.initials: RC
authors.lastname: Costa Filho
authors.affiliation: AMIB.
authors.forename: Gleida Alves
authors.initials: GA
authors.lastname: Borges
authors.affiliation: Unidade coronariana, Hospital evangélico de Cachoeiro de Itapemirim, ES.
authors.forename: Hemerson Casado
authors.initials: HC
authors.lastname: Gama
authors.affiliation: SBN.
authors.forename: Marcellus Gazola
authors.initials: MG
authors.lastname: Grilo
authors.affiliation: UFRJ.
authors.forename: Kerginaldo Paulo
authors.initials: KP
authors.lastname: Torres
authors.affiliation: AMIB.
authors.forename: Rubens Sérgio da Silva
authors.initials: RS
authors.lastname: Franco
authors.affiliation: AMIB.
authors.forename: Jorge Eduardo Silva Soares
authors.initials: JE
authors.lastname: Pinto
authors.affiliation: AMIB.
authors.forename: Cid Marcos
authors.initials: CM
authors.lastname: David