Red blood cell transfusion in non-bleedingcritically ill patients with moderateanemia: is there a benefit?

Abstract Purpose: This study
was undertaken to investigate the
efficacy of red blood cell transfusion
(RBCT) at reversing the deleterious
effects of moderate anemia in critically
ill, non-bleeding patients.
Methods: This was a retrospective,
pair-matched (ratio 1:1) cohort study.
Non-bleeding critically ill patients
with moderate anemia (nadir hemoglobin
level between 70 and 95 g/l),
admitted to the ICU over a 27-month
period, were included. Anemic
patients were included upon meeting
five matching criteria of having the
same nadir hemoglobin (±5 g/l),
APACHE II score (±5), SOFA score
(±2), admission diagnostic group,
and age (±5 years). Outcome events
occurring over the whole ICU stay
and after RBCT were collected. After
hospital discharge, all patients had a
2-year follow-up period. Results:
Two hundred fourteen non-transfused
anemic patients (NTAPs) were successfully
matched with 214
transfused anemic patients (TAPs). In
addition to the matching criteria, at
baseline, both groups were homogenous
with respect to multiple
comorbidities. Compared with TAPs,
NTAPs showed significantly lower
rates of hospital mortality (21
vs.13 %, respectively; p�.05) and
ICU re-admission (7.4 vs. 1.9 %,
respectively; p�.05). Additionally,
NTAPs had significantly lower rates
of nosocomial infection (12.9 vs.
6.7 %, respectively; p�.05) and
acute kidney injury (24.8 vs. 16.7 %,
respectively; p�.05). Similar
results were obtained in subgroup
analysis where only more anemic
patients (68 matched pairs) or patients
with cardiovascular comorbidities (63
matched pairs) were considered.
Conclusions: RBCT does not
improve the clinical outcome in nonbleeding
critically ill patients with
moderate anemia.