2Department of Internal Medicine, Division of Intesive Care, Erciyes University School of Medicine, Kayseri, Turkey
Abstract
Objective: Anaemia, thrombocytopenia, leucopenia, disseminated intravascular coagulation (DIC) and functional deficiencies of coagulation factors are all common in patients with severe sepsis or septic shock. There is no standard protocol for blood and blood product transfusion for this disease. The aim of this study is to evaluate prospectively the blood and blood products transfusion in patients who are diagnosed with sepsis and septic shock.
Material and Methods: This prospective descriptive study was performed on patients who are 18 years of age and over, with septic/septic shock who stay for 48 hours or more in the intensive care unit.
Results: One hundred three patients were enrolled in this study. Fifty six percent of the patients were male and fourty four percent were female. The mean age was 60.9±17.2 years. APACHE II score of the patients was 23.2±4.1. Patients were included in study in 6 (1-22) hours after being diagnosed with sepsis or septic shock in the intensive care unit. Patients were monitored for 6 (3-26) days as sepsis or septic shock. Blood and blood products were transfused to the 67 patients (65%). The most frequently transfused blood product was red blood cell suspension and the second most frequently trans-fused blood product was platelet suspension. Red blood cell suspension was transfused to 56% of the patients. The pre-transfusion Hb values of patients transfused erythrocyte suspension was 8.6±1.5 g/dL. A total of 167 units of red blood cell suspension were transfused. Hemoglobin decrease was the most common cause of red blood cell transfusion. A part of 94.8% patients who received red blood cell transfusion died. The mortality rate was statistically higher in the group of red blood cell transfusion compared to the group without transfusion (p=0.005). Platelet suspension was transfused to 30% of the patients. The pretransfusion platelet values of patients transfused platelet suspension was 23000 (6000-191000) 103/µL. A total of 163 units of platelet suspension were transfused. Thrombocytopenia was the most common cause of platelet transfusion. All of patients who received platelet transfusion died. Patients mortality rate was 86% in intensive care unit.
Conclusion: Patients with sepsis and septic shock who are followed up in intensive care unit are transfused high percent blood and blood products. The most transfused blood products were red blood cell and platelet suspensions. The mortality was higher in patients transfused blood and blood products.