Abstract: Poster Presentations |


Jeannette M. Ploetz, PharmD*; Omar Badawi, PharmD; Brian A. Rosenfeld, MD
Author and Funding Information

The Johns Hopkins Hospital, Baltimore, MD


Chest. 2008;134(4_MeetingAbstracts):p60004. doi:10.1378/chest.134.4_MeetingAbstracts.p60004
Text Size: A A A
Published online


PURPOSE: Restrictive blood transfusion strategies improve outcomes in intensive care unit (ICU) patients yet the 2004 CRIT trial reported that while 44% of ICU patients receive transfusions, only <8% were at the recommended hemoglobin concentration (Hgb) <7g/dL. The objective of this study was to describe current transfusion practices and determine if adherence with guidelines has improved over time.

METHODS: We performed a retrospective multicenter analysis of quarterly ICU blood transfusion data from the eICU® Program Network database over 3 years (1/05 to 12/07). Patients with hemorrhage, trauma, acute coronary syndrome, burns or admission to a neurocritical care unit were excluded. A transfusion (defined as each unit of blood administered) was considered appropriate if the lowest Hgb in the 24 hrs preceding each transfusion was <7g/dL. The primary outcome was the percentage of appropriate transfusions. The secondary outcome was the trend in appropriate transfusions over time. A subgroup analysis compared transfusion practices between community and academic hospitals. Negative binomial regression was used to examine trends and Chi-square to compare groups.

RESULTS: 46,283 patients from 175 hospitals and 316 ICUs received 128,231 blood transfusions between 2005 and 2007. Of these transfusions, 11.8% were appropriate (Hgb <7g/dL) while 65.6% were associated with a Hgb <9g/dL. Between 1/05 and 12/07, appropriate transfusions increased at a rate of 5.9% per quarter (6.9% to 15.2%; p<0.0001). 15.2% of transfusions were appropriate in academic hospitals compared with 9.5% in community hospitals (p<0.0001).

CONCLUSION: Restrictive transfusion strategies are not widely followed, however, in this population adherence has more than doubled between 2005 and 2007. Transfusions administered in academic hospitals were more likely to be associated with a Hgb <7g/dL.

CLINICAL IMPLICATIONS: Adoption of guidelines is increasing but the majority of transfusions still occur with a Hgb >7 g/dL. Further strategies are needed to reduce the number of transfusions associated with a Hgb >7g/dL in both academic and community hospitals.

DISCLOSURE: Jeannette Ploetz, Employee Dr. Badawi: VISICU employee; Dr. Rosenfeld: VISICU employee; No Product/Research Disclosure Information

Tuesday, October 28, 2008

1:00 PM - 2:15 PM




Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
Evidence-Based Medicine in the ICU*: Important Advances and Limitations
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543