Hemodynamics, fluids & transfusion
Adherence to a restrictive red blood cell transfusion strategy in critically ill patients: An observational study
Authors' conclusion
Implementation of a restrictive transfusion trigger in a critical care setting resulted in lasting decreased RBC transfusion use and costs, decreased prescribed and actual haemoglobin trigger levels and improved adherence to prescribed haemoglobin trigger levels.
Study context
- Population
- Critically ill adults without massive bleeding, 9-bed tertiary ICU
- Participants
- 5,626 admissions
- Exposure
- Post-cohort vs pre-cohort
- Post-cohortn = 1,253
- Pre-cohortn = 4,373reference
- Outcome
- RBC usage, haemoglobin trigger levels and adherence to prescribed trigger levels
Methodological detailsbefore-after (pre-cohort vs post-cohort), single-centre, Implementation measures: lectures, webinars and feedback during clinical practice
- Before-after (pre-cohort vs post-cohort)
- Single-centre
- Implementation measures: lectures, webinars and feedback during clinical practice
Main finding
As reported in the abstract
P < 0.001
- Estimated median saving per 100 admission days after implementation
- 1128 €
Observational data: associations, not effects.
Further findings
Admissions receiving RBC transfusion(s) · days 0-10
P < 0.001
Days without compliance with prescribed transfusion trigger
P < 0.001
Prescribed haemoglobin trigger level (determined by intensivist)
P < 0.001
| Outcome | Pre-cohort | Post-cohort | P value |
|---|---|---|---|
| Actual haemoglobin trigger level (prior to transfusion) | median 89 (IQR 82–96) g/L | median 83 (IQR 79–94) | P < 0.001 |
Sensitivity analyses excluding TBI, ischemic heart disease and COVID-19
- Similar results
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →