ScvO2 changes after red‐blood‐cell transfusion for anaemia in cardiothoracic and vascular ICU patients: an observational study

N. Zeroual; G. Samarani; J. Gallais; G. Culas; M. Saour; M. Mourad; P. Gaudard; P. H. Colson

doi:10.1111/vox.12610

journal article Oct 29, 2017

ScvO2 changes after red‐blood‐cell transfusion for anaemia in cardiothoracic and vascular ICU patients: an observational study

N. Zeroual G. Samarani J. Gallais G. Culas M. Saour M. Mourad P. Gaudard P. H. Colson

Vox Sanguinis Vol. 113 No. 2 pp. 136-142 · Wiley

View at Publisher Save 10.1111/vox.12610

Abstract

Background and ObjectivesHaemoglobin threshold for transfusion has been significantly decreased, but haemoglobin plasma concentration may not be sufficient to assess the need of red‐blood‐cell (RBC) transfusion. Central venous oxygen saturation (ScvO2) is a clue of metabolic matching between O2 transport and consumption, which could help to assess when transfusion is appropriate once anaemia has been diagnosed in ICU patients.Materials and MethodsAdult patients admitted consecutively to a cardiothoracic and vascular ICU were included in a prospective, observational and single‐centre study over a 6‐month period (September 2014 to February 2015), provided they were transfused with RBC. Patients with active bleeding or in unstable condition were excluded. Haemoglobin and ScvO2 were collected through a central venous catheter before and after transfusion. In order to identify a ScvO2 threshold, analysis of ScvO2 changes after transfusion was performed.ResultsFifty‐three patients received 100 RBC transfusions. Haemoglobin at the time of transfusion was 7·2 g/dl [6·8–7·7], while ScvO2 was 66·9% [60–73]. A 5% increase in ScvO2 after transfusion has the best specificity and positive predictive values, with a ScvO2 threshold of 65%. After transfusion (RBC units, 2 [1‐2]), ScvO2 increased only in patients with ScvO2 ≤65%, from 58% [53–62] to 69% [64–73] (P < 0·001).ConclusionIn anaemic patients, RBC transfusion induced a significant increase in ScvO2, provided it was low before transfusion. A 65% cut‐off value of ScvO2 before transfusion showed good specificity and good positive predictive value for a 5% increase after transfusion.

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Details

Published: Oct 29, 2017
Vol/Issue: 113(2)
Pages: 136-142
License: View

Authors

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N. Zeroual