Effects of red blood cell transfusion on hemodynamic parameters: a prospective study in intensive care unit patients

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Wolfgang Huber²  Roland M Schmid²  Marlena Messer²  Agnes S Meidert²  Caroline Schultheiss²  Veit Phillip²  Alexander Hapfelmeier¹  Michaela Klein²  Bernd Saugel² 

[1] Institut für Medizinische Statistik und Epidemiologie, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Strasse 22, München, 81675, Germany;II. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Strasse 22, München 81675, Germany

关键词: Critical care;    Hemodynamic monitoring;    Transpulmonary thermodilution;    Transfusion;    Red blood cells;   

Others  :  811581
DOI  :  10.1186/1757-7241-21-21

 received in 2012-12-25, accepted in 2013-03-16,  发布年份 2013

【 摘 要 】

Background

The aim of the study was to investigate the effect of red blood cell (RBC) transfusion on hemodynamic parameters including transpulmonary thermodilution (TPTD)-derived variables.

Methods

We compared hemodynamic parameters obtained before and after RBC transfusion (2 RBC units) in 34 intensive care unit (ICU) patients.

Results

Directly after RBC transfusion, we observed a significant increase in hematocrit (28 ± 3 vs. 22 ± 2%, p < 0.001), hemoglobin (9.4 ± 0.9 vs. 7.6 ± 0.8 g/dL, p < 0.001), arterial oxygen content (CaO₂) (12.2 ± 1.2 vs. 9.9 ± 1.0 mL/dL, p < 0.001), and oxygen delivery (DO₂) (1073 ± 369 vs. 934 ± 288 mL/min, p < 0.001) compared with baseline. Cardiac output (CO) (8.89 ± 3.06 vs. 9.42 ± 2.75 L/min, p = 0.020), cardiac index (CI) (4.53 ± 1.36 vs. 4.82 ± 1.21 L/min/m², p = 0.016), and heart rate (91 ± 16 vs. 95 ± 14 bpm, p = 0.007) were significantly lower following RBC transfusion while no significant change in stroke volume (SV) was observed. Mean arterial pressure (MAP) (median 87 vs. 78 mmHg, p < 0.001) and systemic vascular resistance index (SVRI) (median 1212 vs. 1103 dyn*s*cm^-5*m², p = 0.001) significantly increased directly after RBC transfusion. Global end-diastolic volume index (GEDVI), extravascular lung water index (EVLWI), and pulmonary vascular permeability index (PVPI) did not significantly change.

Conclusions

In ICU patients, the transfusion of 2 RBC units induces a significant decrease in CO and CI because of a significant decrease in heart rate (while SV remains unchanged). Despite the decrease in CO, DO₂ significantly increases because of a significant increase in CaO₂. In addition, RBC transfusion results in a significant increase in MAP and SVRI. No significant changes in TPTD-parameters reflecting cardiac preload (GEDVI), pulmonary edema (EVLWI), and pulmonary vascular permeability (PVPI) are observed following RBC transfusion.

【 授权许可】

   
2013 Saugel et al.; licensee BioMed Central Ltd.

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