Editorial: Med Intensiva
Quintana Díaz M, Sánchez Casado M, Leal Noval SR, García de Lorenzo Y Mateos A; Grupo de Trabajo de Hemoderivados y Alternativas Transfusionales.
INTRODUCTION: Blood derivatives are clinical products that are currently used, for which their lack of availability, clinical relevance and presence of associated side effect that make it necessary to known and evaluate their utility rigorously are characteristic. OBJECTIVE: To analyze knowledge of attitudes, knowledge and behavior on transfusional policy in the different Spanish Intensive Care Units (ICU). DESIGN: A mail-based survey (electronic and conventional) in the ICUs. DURATION: The study was planned in 2005 and conducted during the year 2006. SETTING: Spanish ICUs. PATIENTS AND METHOD: A 27-question questionnaire. RESULTS: Most are middle-sized ICUs (10-20 beds), with predominantly medical activities. The staff member, alone or with the resident, generally decides the transfusion based on his/her experience, although with a tendency to follow the scientific guidelines. Generally, there is no transfusional committee. When red blood packs are transfused, generally between 2 to 4 units are used. The hemoglobin value is orientative, although the decision is clear if < 7 g/dl (10 g/dl if there is heart disease). Drug alternatives to transfusion are not generally used due to lack of evidence and price. In 50% of cases, the association between transfusion and increase in mortality is considered to be certain. CONCLUSIONS: Strong consideration must be made about transfusion and its over use should be avoided. For this purpose, educational guidelines and consensus meetings are necessary to establish recommendations on the use of blood products and their pharmacological alternatives.