{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T22:49:48Z","timestamp":1757544588272,"version":"3.41.0"},"reference-count":28,"publisher":"Scientific Scholar","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec>\n            <jats:title>Background &amp; objectives:<\/jats:title>\n            <jats:p>Current practice around transfusion trigger in critically ill sepsis patients is not clear. Moreover, any association of haemoglobin trigger and other transfusion parameters such as age of red blood cells (RBCs) at transfusion and number of units of RBCs transfused with mortality and other adverse outcomes need further assessment.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>In this prospective study, patients aged 18-70 yr and admitted to intensive care with a diagnosis of sepsis were included (n=108). Baseline demographic, clinical and laboratory parameters were noted and various transfusion data, <jats:italic toggle=\"yes\">i.e<\/jats:italic>., haemoglobin trigger, number of units of RBCs and the age of RBCs were recorded. Following outcome data were collected: 28 and 90 day mortality, duration of mechanical ventilation, vasopressor therapy, intensive care unit (ICU) and hospital stay and requirement of renal replacement therapy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Of the total 108 participants, 78 (72.2%) survived till 28 days and 66 (61.1%) survived till 90 days. Transfusion trigger was 6.9 (6.7-7.1) g\/dl [median (interquartile range)]. On multivariable logistic regression analysis, acute physiology and chronic health evaluation (APACHE) II [adjusted odds ratio (aOR) (95% confidence interval {CI}): 0.86 (0.78, 0.96); <jats:italic toggle=\"yes\">P<\/jats:italic>=0.005], cumulative fluid balance (CFB) [aOR (95% CI): 0.99 (0.99, 0.99); <jats:italic toggle=\"yes\">P<\/jats:italic>=0.005] and admission platelet count [aOR (95% CI): 1.69 (1.01, 2.84); <jats:italic toggle=\"yes\">P<\/jats:italic>=0.043] were the predictors of 28 day mortality [model area under the receiver operating characteristics (AUROC) 0.81]. APACHE II [aOR (95% CI): 0.88 (0.81, 0.97); <jats:italic toggle=\"yes\">P<\/jats:italic>=0.013], CFB [a OR (95% CI): 0.99977 (0.99962, 0.99993); <jats:italic toggle=\"yes\">P<\/jats:italic>=0.044] and transfusion trigger [aOR (95% CI): 3 (1.07, 8.34); <jats:italic toggle=\"yes\">P<\/jats:italic>=0.035] were the predictors of 90 day mortality (model AUROC: 0.82).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Interpretation &amp; conclusions:<\/jats:title>\n            <jats:p>In sepsis, patients admitted to the ICU, current practice suggests transfusion trigger is below 7 g\/dl and it does not affect any adverse outcome including 28 day mortality.<\/jats:p>\n          <\/jats:sec>","DOI":"10.4103\/ijmr.ijmr_329_22","type":"journal-article","created":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T03:08:58Z","timestamp":1696388938000},"page":"276-283","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Transfusion trigger in the critically ill with sepsis or septic shock: A prospective study"],"prefix":"10.25259","volume":"158","author":[{"given":"Mohd.","family":"Mustahsin","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine & Critical Care, Era\u2019s Lucknow Medical College, Lucknow, Uttar Pradesh, India"},{"name":"Department of Anaesthesiology, Pain Medicine & Critical Care, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Souvik","family":"Maitra","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pain Medicine & Critical Care, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahul Kumar","family":"Anand","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pain Medicine & Critical Care, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manish","family":"Soneja","sequence":"additional","affiliation":[{"name":"Department of Medicine, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karan","family":"Madan","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanlal","family":"Darlong","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pain Medicine & Critical Care, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dalim Kumar","family":"Baidya","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pain Medicine & Critical Care, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2023,9,16]]},"reference":[{"key":"R1-20241212","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The third international consensus definitions for sepsis and septic shock (sepsis-3)","volume":"315","author":"Singer","year":"2016","journal-title":"JAMA"},{"key":"R2-20241212","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1097\/01.CCM.0000104112.34142.79","article-title":"The CRIT study:Anemia and blood transfusion in the critically ill \u2013Current clinical practice in the United States","volume":"32","author":"Corwin","year":"2004","journal-title":"Crit Care Med"},{"key":"R3-20241212","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1378\/chest.108.3.767","article-title":"RBC transfusion in the ICU Is there a reason?","volume":"108","author":"Corwin","year":"1995","journal-title":"Chest"},{"key":"R4-20241212","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1001\/jama.288.12.1499","article-title":"Anemia and blood transfusion in critically ill patients","volume":"288","author":"Vincent","year":"2002","journal-title":"JAMA"},{"key":"R5-20241212","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1097\/ACO.0b013e32830f1fd1","article-title":"The silent risks of blood transfusion","volume":"21","author":"Rawn","year":"2008","journal-title":"Curr Opin Anaesthesiol"},{"key":"R6-20241212","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1046\/j.1537-2995.1990.30790385527.x","article-title":"Mechanisms of transfusion-induced immunosuppression","volume":"30","author":"Brunson","year":"1990","journal-title":"Transfusion"},{"key":"R7-20241212","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1056\/NEJM199902113400601","article-title":"A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. Transfusion requirements in critical care investigators, Canadian critical care trials group","volume":"340","author":"H\u00e9bert","year":"1999","journal-title":"N Engl J Med"},{"key":"R8-20241212","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1056\/NEJMoa1406617","article-title":"Lower versus higher hemoglobin threshold for transfusion in septic shock","volume":"371","author":"Holst","year":"2014","journal-title":"N Engl J Med"},{"key":"R9-20241212","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1097\/01.CCM.0000048623.00778.3F","article-title":"Time course of hemoglobin concentrations in nonbleeding intensive care unit patients","volume":"31","author":"Nguyen","year":"2003","journal-title":"Crit Care Med"},{"key":"R10-20241212","doi-asserted-by":"crossref","first-page":"176182","DOI":"10.1155\/2014\/176182","article-title":"Prevalence and severity of anaemia stratified by age and gender in rural India","volume":"2014","author":"Alvarez-Uria","year":"2014","journal-title":"Anemia"},{"issue":"(Suppl 1)","key":"R11-20241212","doi-asserted-by":"crossref","first-page":"P382","DOI":"10.1186\/cc8614","article-title":"Epidemiology of severe sepsis in India:An update","volume":"14","author":"Todi","year":"2010","journal-title":"Crit Care"},{"key":"R13-20241212","doi-asserted-by":"crossref","first-page":"573","DOI":"10.4103\/ijccm.IJCCM_240_17","article-title":"Epidemiology of adult-population sepsis in India:A single center 5 year experience","volume":"21","author":"Chatterjee","year":"2017","journal-title":"Indian J Crit Care Med"},{"key":"R14-20241212","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1056\/NEJMoa010307","article-title":"Early goal-directed therapy in the treatment of severe sepsis and septic shock","volume":"345","author":"Rivers","year":"2001","journal-title":"N Engl J Med"},{"key":"R15-20241212","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1056\/NEJMoa1500896","article-title":"Trial of early, goal-directed resuscitation for septic shock","volume":"372","author":"Mouncey","year":"2015","journal-title":"N Engl J Med"},{"key":"R16-20241212","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1186\/s13054-019-2528-0","article-title":"Trends in sepsis mortality over time in randomised sepsis trials:A systematic literature review and meta-analysis of mortality in the control arm, 2002-2016","volume":"23","author":"Luhr","year":"2019","journal-title":"Crit Care"},{"key":"R17-20241212","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1007\/s00134-017-4683-6","article-title":"Surviving sepsis campaign:International guidelines for management of sepsis and septic shock:2016","volume":"43","author":"Rhodes","year":"2017","journal-title":"Intensive Care Med"},{"key":"R18-20241212","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1186\/s13054-019-2543-1","article-title":"Liberal versus restrictive red blood cell transfusion strategy in sepsis or septic shock:A systematic review and meta-analysis of randomized trials","volume":"23","author":"Hirano","year":"2019","journal-title":"Crit Care"},{"key":"R19-20241212","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1097\/CCM.0000000000002283","article-title":"Liberal versus restrictive transfusion strategy in critically ill oncologic patients:The transfusion requirements in critically ill oncologic patients randomized controlled trial","volume":"45","author":"Bergamin","year":"2017","journal-title":"Crit Care Med"},{"key":"R20-20241212","doi-asserted-by":"crossref","first-page":"e0192","DOI":"10.1097\/MD.0000000000010192","article-title":"Lower hemoglobin transfusion trigger is associated with higher mortality in patients hospitalized with pneumonia","volume":"97","author":"Rahimi-Levene","year":"2018","journal-title":"Medicine (Baltimore)"},{"key":"R21-20241212","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/1471-2466-10-15","article-title":"The prevalence of anemia and its association with 90-day mortality in hospitalized community-acquired pneumonia","volume":"10","author":"Reade","year":"2010","journal-title":"BMC Pulm Med"},{"key":"R22-20241212","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1056\/NEJMoa070403","article-title":"Duration of red-cell storage and complications after cardiac surgery","volume":"358","author":"Koch","year":"2008","journal-title":"N Engl J Med"},{"key":"R23-20241212","doi-asserted-by":"crossref","first-page":"17","DOI":"10.4103\/ajts.AJTS_76_18","article-title":"Impact of stored red cells on clinical outcome in critically ill","volume":"13","author":"Shivhare","year":"2019","journal-title":"Asian J Transfus Sci"},{"key":"R24-20241212","doi-asserted-by":"crossref","first-page":"1937","DOI":"10.1056\/NEJMoa1609014","article-title":"Effect of short-term versus. Long-term blood storage on mortality after transfusion","volume":"375","author":"Heddle","year":"2016","journal-title":"N Engl J Med"},{"key":"R25-20241212","doi-asserted-by":"crossref","first-page":"1410","DOI":"10.1056\/NEJMoa1500704","article-title":"Age of transfused blood in critically ill adults","volume":"372","author":"Lacroix","year":"2015","journal-title":"N Engl J Med"},{"key":"R26-20241212","doi-asserted-by":"crossref","first-page":"1858","DOI":"10.1056\/NEJMoa1707572","article-title":"Age of red cells for transfusion and outcomes in critically ill adults","volume":"377","author":"Cooper","year":"2017","journal-title":"N Engl J Med"},{"key":"R27-20241212","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1056\/NEJMoa067373","article-title":"Vasopressin versus norepinephrine infusion in patients with septic shock","volume":"358","author":"Russell","year":"2008","journal-title":"N Engl J Med"},{"key":"R28-20241212","doi-asserted-by":"crossref","first-page":"1891","DOI":"10.1097\/CCM.0000000000001835","article-title":"Cumulative fluid balance and mortality in septic patients with or without acute kidney injury and chronic kidney disease","volume":"44","author":"Neyra","year":"2016","journal-title":"Crit Care Med"},{"key":"R29-20241212","doi-asserted-by":"crossref","first-page":"708","DOI":"10.4103\/0972-5229.171356","article-title":"Impact of positive fluid balance on mortality and length of stay in septic shock patients","volume":"19","author":"Koonrangsesomboon","year":"2015","journal-title":"Indian J Crit Care Med"}],"container-title":["Indian Journal of Medical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.4103\/ijmr.ijmr_329_22","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T23:06:46Z","timestamp":1751497606000},"score":1,"resource":{"primary":{"URL":"https:\/\/ijmr.org.in\/transfusion-trigger-in-the-critically-ill-with-sepsis-or-septic-shock-a-prospective-study\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9]]},"references-count":28,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/ijmr.ijmr_329_22","relation":{},"ISSN":["0971-5916","0975-9174"],"issn-type":[{"type":"print","value":"0971-5916"},{"type":"electronic","value":"0975-9174"}],"subject":[],"published":{"date-parts":[[2023,9]]},"assertion":[{"value":"2022-02-07","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}}]}}