Evaluation of the quotient of the venoarterial carbon dioxide gradient and the arteriovenous oxygen content difference as a transfusion trigger parameter in hemodynamically stable patients with significant anemia

A Taha,A Shafie,M Mostafa,H Hon,R Marktanner,N Syed

doi:10.1186/cc14411

Abstract

Hemoglobin as the main trigger parameter for blood transfusion usually gives diminutive information about oxygen delivery and consumption. Although central venous oxygen saturation (ScvO2) is an alternative parameter, its changes are unable to detect regional hypoxia. Our aim was to evaluate the quotient of the central venous-toarterial carbon dioxide gradient (δPCO2) and the arteriovenous oxygen content difference (Ca-cvO2) as a valid transfusion trigger parameter in hemodynamically stable anemic patients to reduce the amount of potentially counterproductive erythrocyte transfusions [1].

Highlights

To assess cerebral hemodynamics in an experimental sepsis model
Healthy bowel function is an important factor when judging the advisability of early enteral nutrition in critically ill patients
Since the Surviving Sepsis Campaign (SSC) in 2002, the Health Service Ombudsman for England published recommendations for improving recognition and treatment of sepsis [2], the Royal College of Physicians issued a toolkit for the management of sepsis in the acute medical unit [3], and NHS England released a patient safety alert to support prompt recognition and treatment of sepsis [4]

Summary

Introduction

We evaluated platelet activation markers as potential predictive markers of sepsis and of mortality among four commonly encountered populations of patients admitted to ICUs. Methods Ninety-nine non-infected ICU patients were prospectively screened at day 1 (T1) and day 3 (T2) of admission after elective cardiac surgery, trauma, acute neurologic dysfunction or prolonged ventilation (>48 hours). The present study was performed with the aim of assessing whether nursing and physician staff were able to identify patients in need of critical care using only clinical judgment and to compare this with the National Early Warning Score (NEWS) Methods This was a prospective cohort study of all adult patients with a first-time admission to a medical admission unit at a 450-bed regional teaching hospital over a 3-month period in 2010.

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