Abstract
Background
The exact role of packed red blood cell (PRBC) transfusion in the setting of early
resuscitation in septic shock is unknown.
Study Objective
To evaluate whether PRBC transfusion is associated with improved central venous oxygen
saturation (ScvO2) or organ function in patients with severe sepsis and septic shock receiving early
goal-directed therapy (EGDT).
Methods
Retrospective cohort study (n=93) of patients presenting with severe sepsis or septic shock treated with EGDT.
Results
Thirty-four of 93 patients received at least one PRBC transfusion. The ScvO2 goal>70% was achieved in 71.9% of the PRBC group and 66.1% of the no-PRBC group (p=0.30). There was no difference in the change in Sequential Organ Failure Assessment
(SOFA) score within the first 24 h in the PRBC group vs. the no-PRBC group (8.6–8.3 vs. 5.8–5.6, p=0.85), time to achievement of central venous pressure>8 mm Hg (732 min vs. 465 min, p=0.14), or the use of norepinephrine to maintain mean arterial pressure>65 mm Hg (81.3% vs. 83.8%, p=0.77).
Conclusions
In this study, the transfusion of PRBC was not associated with improved cellular oxygenation,
as demonstrated by a lack of improved achievement of ScvO2>70%. Also, the transfusion of PRBC was not associated with improved organ function
or improved achievement of the other goals of EGDT. Further studies are needed to
determine the impact of transfusion of PRBC within the context of early resuscitation
of patients with septic shock.
Keywords
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Article info
Publication history
Published online: March 26, 2012
Accepted:
January 20,
2012
Received in revised form:
July 15,
2011
Received:
February 14,
2011
Footnotes
Work was done at Cooper University Hospital, Camden, NJ.
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
