RT Book, Section
A1 Shander, Aryeh
A1 Gianatiempo, Carmine
A1 Goodnough, Lawrence T.
A2 Oropello, John M.
A2 Pastores, Stephen M.
A2 Kvetan, Vladimir
SR Print(0)
ID 1136414912
T1 Transfusion Medicine in Critical Care
T2 Critical Care
YR 1
FD 1
PB McGraw-Hill Education
PP New York, NY
SN 9780071820813
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1136414912
RD 2024/04/24
AB KEY  POINTSPatient  blood  management  (PBM)  is  the  timely  application  of  evidence-based  medical  and  surgical  concepts  designed  to  maintain  hemoglobin  (Hb)  concentration,  optimize  hemostasis,  and  minimize  blood  loss  in  an  effort  to  improve  patient  outcome.Anemia  in  the  critically  ill  patients  is  often  multifactorial  and  can  be  traced  to  one  or  a  combination  of  iron  deficiency,  inflammatory  responses,  blunt  response  to  endogenous  erythropoietin,  bleeding  and  aggressive  diagnostic  blood  draws  that  are  common  in  many  intensive  care  units  (ICUs).The  use  of  hemoglobin  as  the  only  “trigger”  for  red  blood  cell  (RBC)  transfusion  should  be  avoided,  and  transfusion  decisions  should  be  made  based  on  other  parameters  such  as  patient's  volume  status,  evidence  of  shock,  duration,  and  severity  of  anemia,  and  cardiopulmonary  status  of  the  patient.The  benefit  of  fresh  frozen  plasma  (FFP)  administration  remains  controversial  and  with  the  advent  of  more  specific  factor  concentrates,  its  indications  are  on  the  decline.Higher  plasma  (and  platelet)  to  RBC  ratios  as  part  of  “balanced”  transfusion  protocols  during  early  resuscitation  of  trauma  patients  may  be  associated  with  better  survival,  but  is  still  under  investigation.