title: [Therapy with blood products].
abstract: Blood products are frequently used in intensive care medicine although there is little evidence of improvement in clinical outcome. The threshold for erythrocyte transfusion in non-bleeding critically ill patients is currently a hemoglobin level of 7.0 g/dl. The indications for platelet transfusion must be assessed after evaluation of the cause of thrombocytopenia, the clinical condition and the expected effect. The use of plasma should also be critically viewed, mainly due to hypervolemia. Prothrombin complex concentrates are better than plasma for warfarin reversal. There is good evidence for the use of albumin for massive paracentesis, in the treatment of hepatorenal syndrome type 1 and spontaneous bacterial peritonitis. Albumin infusion can have favorable effects in severe sepsis and septic shock. A restrictive strategy should be favored in the use of blood products and the decision should be based on a critical appraisal of the available evidence.
authors.affiliation: Interdisziplinäre Internistische Intensivmedizin, Zentrum für Hämostaseologie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland. sirak.petros@medizin.uni-leipzig.de.
authors.forename: S
authors.initials: S
authors.lastname: Petros
mesh_terms: D001779:Blood Coagulation Factors / Q000627:therapeutic use*; D016913:Blood Component Transfusion / Q000379:methods*; D003422:Critical Care / Q000379:methods*; D019317:Evidence-Based Medicine; D005858:Germany; D019983:Guideline Adherence; D006801:Humans; D010949:Plasma; D012709:Serum Albumin / Q000627:therapeutic use*
chemical_list: D001779:Blood Coagulation Factors; D012709:Serum Albumin
keywords: Blood coagulation factors; Blood platelets; Erythrocytes; Plasma; Serum albumin
references.citation: J Thromb Haemost. 2005 Sep;3(9):1935-44
references.pmid: 16102099
references.citation: Crit Care. 2006;10(4):R120
references.pmid: 16919168
references.citation: Ann Intern Med. 2015 Feb 3;162(3):205-13
references.pmid: 25383671
references.citation: Chirurg. 1984 Dec;55(12):803-8
references.pmid: 6394228
references.citation: Ann Emerg Med. 2016 Jan;67(1):96-105.e5
references.pmid: 26094105
references.citation: Transfusion. 2015 Nov;55(11):2722-9
references.pmid: 26135740
references.citation: Transfusion. 1999 Oct;39(10):1070-7
references.pmid: 10532600
references.citation: N Engl J Med. 2013 Jan 3;368(1):11-21
references.pmid: 23281973
references.citation: J Am Heart Assoc. 2015 Jun 02;4(6):e002066
references.pmid: 26037084
references.citation: Transfusion. 2010 Jun;50(6):1370-83
references.pmid: 20345563
references.citation: Anesthesiology. 2009 Feb;110(2):239-45
references.pmid: 19194150
references.citation: Ann Intern Med. 2012 Jul 3;157(1):49-58
references.pmid: 22751760
references.citation: Circulation. 2013 Sep 10;128(11):1234-43
references.pmid: 23935011
references.citation: Injury. 2011 Jul;42(7):697-701
references.pmid: 21392760
references.citation: N Engl J Med. 2014 Oct 9;371(15):1381-91
references.pmid: 25270275
references.citation: N Engl J Med. 2004 May 27;350(22):2247-56
references.pmid: 15163774
references.citation: Hematology Am Soc Hematol Educ Program. 2007;:172-8
references.pmid: 18024626
references.citation: N Engl J Med. 1999 Aug 5;341(6):403-9
references.pmid: 10432325
references.citation: J Thromb Haemost. 2006 Jan;4(1):90-7
references.pmid: 16409457
references.citation: N Engl J Med. 2008 May 15;358(20):2127-37
references.pmid: 18480205
references.citation: J Clin Oncol. 1997 Mar;15(3):1143-9
references.pmid: 9060557
references.citation: Lancet. 2003 Jan 18;361(9353):201-5
references.pmid: 12547542
references.citation: Haemophilia. 2008 Nov;14(6):1151-8
references.pmid: 19141154
references.citation: N Engl J Med. 2014 Apr 10;370(15):1412-21
references.pmid: 24635772
references.citation: Lancet. 2015 May 23;385(9982):2077-87
references.pmid: 25728933
references.citation: Transfusion. 2010 Jun;50(6):1227-39
references.pmid: 20345562
references.citation: Hepatology. 2008 May;47(5):1604-14
references.pmid: 18393319
references.citation: J Hepatol. 2010 Sep;53(3):397-417
references.pmid: 20633946
references.citation: Hepatology. 2016 Feb;63(2):566-73
references.pmid: 26340411
references.citation: Crit Care. 2013 Apr 19;17(2):R76
references.pmid: 23601765
references.citation: Anesth Analg. 1995 Aug;81(2):360-5
references.pmid: 7542432
references.citation: Dtsch Med Wochenschr. 1982 Dec 10;107(49):1882-6
references.pmid: 6754328
references.citation: J Trauma. 2005 Jul;59(1):8-15; discussion 15-8
references.pmid: 16096533
references.citation: Br J Haematol. 1997 Dec;99(3):542-7
references.pmid: 9401063
references.citation: Br J Anaesth. 2005 May;94(5):586-91
references.pmid: 15734783
references.citation: Z Gastroenterol. 1999 Oct;37(10):999-1004
references.pmid: 10549094
references.citation: N Engl J Med. 2011 Dec 29;365(26):2453-62
references.pmid: 22168590
references.citation: JAMA. 2001 Oct 17;286(15):1869-78
references.pmid: 11597289
references.citation: Anesthesiology. 2013 Jan;118(1):40-50
references.pmid: 23249928
references.citation: Liver Transpl. 2005 Aug;11(8):973-9
references.pmid: 16035095
references.citation: Intensive Care Med. 2013 Feb;39(2):165-228
references.pmid: 23361625
references.citation: JAMA. 2006 Jan 18;295(3):293-8
references.pmid: 16418464
references.citation: Biol Blood Marrow Transplant. 2002;8(10):569-76
references.pmid: 12434952
references.citation: Transfusion. 2005 Jul;45(7):1064-72
references.pmid: 15987349
references.citation: Transfus Med Rev. 2004 Jul;18(3):153-67
references.pmid: 15248165
references.citation: Transfus Apher Sci. 2004 Aug;31(1):55-66
references.pmid: 15294196
references.citation: Blood. 1985 Nov;66(5):1105-9
references.pmid: 4052629
references.citation: Thromb Haemost. 2015 Apr;113(4):686-97
references.pmid: 25652913
references.citation: N Engl J Med. 1999 Feb 11;340(6):409-17
references.pmid: 9971864