RBC transfusion in the ICU. Is there a reason?

Chest. 1995 Sep;108(3):767-71. doi: 10.1378/chest.108.3.767.


Objective: To evaluate RBC transfusion practice in the ICU.

Design: Retrospective chart review.

Setting: Multidisciplinary ICU in a tertiary care center.

Patients: All patients admitted to the ICU with a length of stay of greater than 1 week.

Results: A total of 23% of all patients admitted to the ICU had a length of stay of greater than 1 week (19.6 +/- 1.6 days). Of these patients, 85% received blood transfusions (9.5 +/- 0.8 U per patient). These transfusions were not solely a function of acute blood loss. Patients were transfused a constant 2 to 3 U/wk. Patients receiving blood transfusions were phlebotomized on average 61 to 70 mL per day. Phlebotomy accounted for 49% of the variation in amount of RBCs transfused. No indication for blood transfusion was identified for 29% of transfusion events. A low hematocrit (< 25%) was the only identifiable indication in an additional 19% of events. Almost one third of all RBCs transfused were without a clear transfusion indication.

Conclusion: The long-term ICU population receive a large number of blood transfusions. Phlebotomy contributes significantly to these transfusions. There is no clear indication for a large number of the blood transfusions given. Many blood transfusions appear to be administered because of an arbitrary "transfusion trigger" rather than a physiologic need for blood. Blood conservation and adherence to transfusion guidelines could significantly reduce RBC transfusion in the ICU.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bloodletting
  • Case-Control Studies
  • Critical Care
  • Erythrocyte Transfusion / statistics & numerical data*
  • Female
  • Hematocrit
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Retrospective Studies