Transfusion Medicine Flashcards
What is the best treatment with acute blood loss, when considering PRBC transfusion?
SOURCE control
In active bleeding, what HgB level is aimed for?
> 70 g/L
In transfusing for active bleeding, when would you consider more than 70g/L
- Impaired pulmonary function
- CAD or ACS
- Bleeding not readily controlled, unpredictable
What is a difficulty in PRBC transfusion in the ICU?
Difficulty to assess for symptoms of anemia
When would you transfuse for a patient in ICU?
If Hgb
Transfuse or not?
>100 g/L
Likely inappropriate unless exceptional circumstance
Transfuse or not?
70 - 100 g/L
Appropriate of signs/sx of impaired oxygen delivery
Transfuse or not?
Appropriate
Transfuse or not?
Highly recommended
young pts with low risk of ischemic event can tolerate anemia
What were the two arms of the TRICC trial?
ICU patient randomized to
a) restrictive transfusion (Hgb 70-90)
b) liberal transfusion (Hgb 100 -120)
What was the primary outcome assessed for in the TRICC tiral?
Difference in mortality
What was the difference in mortality at 30 days in the TRICC trial?
Similar mortality at 30d
Restrictive strategy superior in younger less critically patients
NOT in MI pts
In TRICC trial, which subgroup of patients did not benefits from the restrictive transfusion strategy?
Those who experienced an active MI
What is PBM?
“Patient blood management “
Timely application of EBM to maintain HgB concentration, optimize hemostasis, and minimize blood loss to improve pt outcomes
Reduces need for allogeneic blood transfusions
What is TACO?
Transfusion associated circulatory overload
