When to Pull the Transfusion Trigger?
Summary by: Anders Perner
The management of the septic patient in ICU is a recurrent topic for debate amongst intensivists. The decision of if and/or when to give blood transfusions is one of the key sources of contention. Dr Anders Perner is one of the most qualified people to weigh in on this debate. In this talk from SMACC Chicago, he delivers his stance on when to pull the transfusion trigger.
Dr Anders Perner is an Intensive Care Specialist at Rigshospitalet and a professor in intensive care at Copenhagen University. He is the chairman of the Scandinavian Critical Care Trials Group and the strategic research program “New resuscitation strategies in patients with severe sepsis’. The contents of this talk are based on the findings of the TRISS trial – Transfusion Requirements in Septic Shock. This trial, Lower versus Higher Hemoglobin Threshold for Transfusion in Septic Shock was published in the NEJM in October 2014. The aim was to evaluate the recommendations from the Surviving Sepsis Campaign regarding transfusion in septic shock. The recommendation is that after the first 6 hours, transfusion threshold should be a Hb <7g/dL aiming for a Hb between 7-9g/dL in patients who do not have MI, severe hypoxia, acute haemorrhage or ischaemic coronary artery disease. Unfortunately, these recommendations were made with limited supporting data, hence the TRISS trial was born.
The TRISS trial was conducted as a multicentre, parallel-group trial run across 32 ICUs in Denmark, Norway, Sweden and Finland. Patients with septic shock who had a Hb
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