1 / 16

Transfusion Thresholds in Critically Ill Cancer Patients: An Overview

Explore the relevance of transfusion thresholds for cancer patients in the ICU, considering limited resources, side effects, and high blood product consumption. Review conflicting studies, mortality rates, infections, bleeding risks, and alternative endpoints.

camillaw
Download Presentation

Transfusion Thresholds in Critically Ill Cancer Patients: An Overview

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Transfusion thresholds for cancer patients Frédéric Pène Medical ICU, Hôpital Cochin, AP-HP, Paris University Paris Descartes Institut Cochin, Inserm U1016, CNRS UMR-8104

  2. No conflict of interest

  3. Does research about transfusion thresholds in critically ill OH patients remain relevant ? • Blood products are limited and expensive resources • Blood products are associated with side effects • OH patients are high consumers of blood products • Cytopenia are most often already present at ICU admission • Translation from studies in general ICU population or stable OH patients to critically ill OH patients is questionable • High risk of death and ICU-acquired complications • Infections • Bleeding • Few but discrepant studies in the field

  4. Number of packed RBC 2.6 ± 4.1 p<0.01 5.6 ± 5.3 Hb > 7 g/dL Hb > 10 g/dL

  5. NEJM 2014

  6. Park, Crit Care Med 2012 Mortality in septic pts

  7. RBC transfusions for early sepsis resuscitation in hemato patients No transfusion Mortality : - D7 : 13.3% vs. 20.5% p = 0,02 - ICU : 25.2% vs. 39% p < 0.001 - Hosp. : 36.6% vs. 49% p < 0.001 Cumulated survival Transfusion Days Mirouse A. for the Grrr-OH, Réanimation congress 2016

  8. Holst, N Engl J Med 2014

  9. RBC transfusion in OH patients with septic shock: the randomized studies

  10. Designing future studies in the field • Still a relevant question? • Restricting vs. promoting RBC transfusions? • Chronic vs. ICU-acquired anemia • Multicenter studies • Should transfusion indications be hemoglobin-based only? • Relevant endpoints? • Mortality (short-term & long-term) • Alternative endpoints • Clinical deterioration/improvement • ICU-acquired complications (infectious and non-infectious)

More Related