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Red blood cell transfusion in the resuscitation of septic patients with hematological malignancies

Overview of attention for article published in Annals of Intensive Care, June 2017
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Title
Red blood cell transfusion in the resuscitation of septic patients with hematological malignancies
Published in
Annals of Intensive Care, June 2017
DOI 10.1186/s13613-017-0292-3
Pubmed ID
Authors

Adrien Mirouse, Matthieu Resche-Rigon, Virginie Lemiale, Djamel Mokart, Achille Kouatchet, Julien Mayaux, François Vincent, Martine Nyunga, Fabrice Bruneel, Antoine Rabbat, Christine Lebert, Pierre Perez, Anne Renault, Anne-Pascale Meert, Dominique Benoit, Rebecca Hamidfar, Mercé Jourdain, Michaël Darmon, Elie Azoulay, Frédéric Pène

Abstract

Indications for red blood cell (RBC) transfusion in septic acute circulatory failure remain unclear. We addressed the practices and the prognostic impact of RBC transfusion in the early resuscitation of severe sepsis and septic shock in patients with hematological malignancies. We performed a retrospective analysis of a prospectively collected database of patients with hematological malignancies who required intensive care unit (ICU) admission in 2010-2011. Patients with a main admission diagnosis of severe sepsis or septic shock were included in the present study. We assessed RBC transfusion during the first two days as part of initial resuscitation. Among the 1011 patients of the primary cohort, 631 (62.4%) were admitted to the ICU for severe sepsis (55%) or septic shock (45%). Among them, 210 (33.3%) patients received a median of 2 [interquartile 1-3] packed red cells during the first 48 h. Hemoglobin levels were lower in transfused patients at days 1 and 2 and became similar to those of non-transfused patients at day 3. Early RBC transfusion was more likely in patients with myeloid neoplasms and neutropenia. Transfused patients displayed more severe presentations as assessed by higher admission SOFA scores and blood lactate levels and the further requirements for organ failure supports. RBC transfusion within the first two days was associated with higher day 7 (20.5 vs. 13.3%, p = 0.02), in-ICU (39 vs. 25.2%, p < 0.001) and in-hospital (51 vs. 36.6%, p < 0.001) mortality rates. RBC transfusion remained independently associated with increased in-hospital mortality in multivariate logistic regression (OR 1.52 [1.03-2.26], p = 0.03) and propensity score-adjusted (OR 1.64 [1.05-2.57], p = 0.03) analysis. RBC transfusion is commonly used in the early resuscitation of septic patients with hematological malignancies. Although it was preferentially provided to the most severe patients, we found it possibly associated with an increased risk of death.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 32 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 32 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 6 19%
Student > Postgraduate 5 16%
Student > Ph. D. Student 5 16%
Researcher 3 9%
Professor > Associate Professor 2 6%
Other 5 16%
Unknown 6 19%
Readers by discipline Count As %
Medicine and Dentistry 17 53%
Nursing and Health Professions 2 6%
Engineering 2 6%
Agricultural and Biological Sciences 1 3%
Neuroscience 1 3%
Other 1 3%
Unknown 8 25%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 24 January 2019.
All research outputs
#12,541,112
of 14,185,573 outputs
Outputs from Annals of Intensive Care
#561
of 623 outputs
Outputs of similar age
#238,477
of 274,958 outputs
Outputs of similar age from Annals of Intensive Care
#2
of 3 outputs
Altmetric has tracked 14,185,573 research outputs across all sources so far. This one is in the 1st percentile – i.e., 1% of other outputs scored the same or lower than it.
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