Use of blood products in sepsis: An evidence-based review

Zimmerman, Janice L.

doi:10.1097/01.ccm.0000145906.63859.1a

Cited by 45 publications

(29 citation statements)

References 59 publications

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“…However, correction of these abnormalities do not necessarily improve the outcomes in all the patients and unnecessarily exposes the child to the risks of blood product transfusions [26]. There are no studies to suggest that correction of more severe coagulation abnormalities benefits patients who are not bleeding.…”

Section: Blood Productsmentioning

confidence: 97%

Management of Septic Shock

2011

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Septic shock is an important cause of mortality in children with sepsis. The incidence of septic shock is 2-4% of admissions in western pediatric intensive care units and 40%-67% for Indian PICUs. Early goal-directed resuscitation that includes aggressive fluid resuscitation of up to 60 mL/kg as boluses of 20 mL/kg by IV push, to achieve desired heart rates and blood pressure, has emerged as mainstay of treatment in the initial stage. Crystalloids are the preferred fluids, while colloids may be used in some situations. Fluid refractory shock warrants use of vasoactive drugs. Dopamine is the first choice. Dobutamine and low dose epinephrine are the preferred inotropic drugs while nor-epinephrine is a vasopressor. Children with cold shock and normal blood pressure may benefit from nitrosodilators like nitroprusside and nitroglycerine. Inodilators such as milrinone are also useful in this situation. Targeting clinical therapeutic end-points assists the management. Good supportive care is also essential for improving the outcomes.

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Section: Blood Productsmentioning

confidence: 97%

Management of Septic Shock

2011

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“…En 2003, des experts internationaux en réanimation et maladies infectieuses ont développé des recommandations sur l'utilisation des produits sanguins dans le sepsis [27]. Pour la transfusion de plaquettes ces recommandations sont gradées E, notamment :…”

Section: Transfusion De Plaquettesunclassified

Thrombopénies en réanimation

Stéphan

2008

Réanimation

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“…Approximately 40-50% of patients admitted to the ICU are transfused at least 1 RBC unit. Several studies have shown that RBC transfusion in sepsis did not improve oxygen delivery, oxygen consumption, mixed venous oxygen saturation or lactate levels [84][85][86].…”

Section: Clinical Evidence For Transfusion In Sepsismentioning

confidence: 99%

Red Blood Cell Transfusion in Sepsis: A Review

Sadaka¹

2013

J Blood Disord Transfus

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Sepsis is very common and lethal. Sepsis is the leading cause of death in non-coronary Intensive Care Units, and the tenth leading cause of death overall. Red blood cell transfusion is one of the most commonly used interventions in the ICU to treat severe anemia, which often occurs in sepsis. Several problems were documented with RBC transfusions and will be reviewed, such as infection, pulmonary complications such as TRALI and Transfusion-Associated Circulatory Overload (TACO), Transfusion-Related Immunomodulation (TRIM) and multiorgan failure, and increased mortality. Most of these complications are partially explained by volume of the unit of blood as well as pathogenic factors of stored RBCs related to 2,3 BPG concentration, inflammatory mediators, nitric oxide, ATP concentration and RBC rheology, and RBC adhesion characteristics. These same factors are present in RBCs of septic patients as well. Until better evidence is available, a "restrictive" strategy of RBC transfusion (transfuse when Hb < 7 g/dL) is recommended except in acute hemorrhage, or in patients with acute myocardial ischemia when a hemoglobin trigger of 8 g/dl is reasonable.

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Use of blood products in sepsis: An evidence-based review

Cited by 45 publications

References 59 publications

Management of Septic Shock

Management of Septic Shock

Thrombopénies en réanimation

Red Blood Cell Transfusion in Sepsis: A Review

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