Blood transfusion for the critically ill

Abstract

The critically ill patients are often multi-systemically dysfunctional and requiring metabolic and/or blood transfusion support. Blood support for patients ranges from whole blood to components (packed cells, platelet concentrate, fresh frozen plasma and growth factor replacement) therapy. The predisposing factors for transfusion in critically ill include sepsis, overt or occult blood loss (including frequent blood sampling), decreased production of endogenous growth factors (e.g. erythropoietin), systemic inflammatory response and immune-associated functional deficiency.
There is a common occurrence of anaemia and wide usage of packed red cells in the critically ill patient. Efficient use of blood and blood components transfusion can improve clinical outcome, restore organ functions, and reduce mortality in the critically ill. There is an increasing need to explore and use growth factors more in the management of critically ill individuals.