Journal Article Review Epublish 22 citations
PubMed: 28891973 DOI: 10.3390/ijms18091946
Transfusion of Red Blood Cells to Patients with Sepsis.
Int J Mol Sci 18(9)
Authors: Yi-Ling Chan, Shih-Tsung Han, Chih-Huang Li, Chin-Chieh Wu, Kuan-Fu Chen
Affiliations
- Department of Emergency Medicine, Chang Gung Memorial Hospital Linkou, Taoyuan 330, Taiwan.
- Department of Emergency Medicine, Chang Gung Memorial Hospital Linkou, Taoyuan 330, Taiwan.
- Department of Emergency Medicine, Chang Gung Memorial Hospital Linkou, Taoyuan 330, Taiwan.
- Department of Emergency Medicine, Chang Gung Memorial Hospital Keelung, Keelung 204, Taiwan.
- Department of Emergency Medicine, Chang Gung Memorial Hospital Linkou, Taoyuan 330, Taiwan.
- Department of Emergency Medicine, Chang Gung Memorial Hospital Keelung, Keelung 204, Taiwan.
- Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan 330, Taiwan.
- Community Medicine Research Center, Chang Gung Memorial Hospital Keelung, Keelung 204, Taiwan.
Abstract
Sepsis is one of the major causes of death worldwide, and is the host response to infection which renders our organs malfunctioning. Insufficient tissue perfusion and oxygen delivery have been implicated in the pathogenesis of sepsis-related organ dysfunction, making transfusion of packed red blood cells (pRBCs) a reasonable treatment modality. However, clinical trials have generated controversial results. Even the notion that transfused pRBCs increase the oxygen-carrying capacity of blood has been challenged. Meanwhile, during sepsis, the ability of our tissues to utilize oxygen may also be reduced, and the increased blood concentrations of lactate may be the results of strong inflammation and excessive catecholamine release, rather than impaired cell respiration. Leukodepleted pRBCs more consistently demonstrated improvement in microcirculation, and the increase in blood viscosity brought about by pRBC transfusion helps maintain functional capillary density. A restrictive strategy of pRBC transfusion is recommended in treating septic patients.
MeSH
Sepsis, Infections, Erythrocytes, Blood Cells, Tissues
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