Retrospective evaluation of anemia development and blood transfusions in patients hospitalized in anesthesia intensive care unit

ABSTRACT RETROSPECTIVE EVALUATION OF ANEMIA DEVELOPMENT AND BLOOD TRANSFUSIONS IN PATIENTS HOSPITALIZED IN ANESTHESIA INTENSIVE CARE UNIT Development of anemia in intensive care unit (ICU) patients is a common problem. We aimed to retrospectively investigate; the incidence of anemia and transfusion, the contribution of blood volume that is taken for diagnostic purposes to the development of anemia, the threshold of hemoglobin (Hb) value used for transfusion and the clinical outcome of transfusion in the patients treated in anesthesia intensive care unit (AICU) in our study. In our study, the data of adult patients who underwent follow-up for longer than 24 hours in AICU between 01.01.2015 - 12.31.2015 were examined. Patients' age, Glasgow Coma Scale (GCS) scores, admission diagnoses and additional disease presence, APACHE II scores, Hb values, diagnostic blood loss and fluid balance, pre-transfusion Hb values, transfusion indications, transfusion-related complications were recorded. Data of male (Group E) and female (Group K) patients were assessed separately and compared. A total of 229 patients (Group E, n = 119; Group K, n = 110) were eligible for the study. 90% of them were evaluated for the first 30 days of hospitalization because most of them stayed in the ICU for less than 30 days. The length of stay, admission factors, admission diseases, APACHE II scores (20.93 ± 6.68 in group E, 21.50 ± 7.33 in group K) and GCS values (median 9) were similar (p> 0.05). 60.7% of the patients (62.2% in Group E, 59.1% in Group K) were anemic on the day they were admitted to ICU. All patients had decreased Hb values over time and anemia was detected in 55.6% of the non-anemic patients from the 3rd day of admission (p <0.001). Women had lower Hb values at all time periods (p <0.05). A Daily average of 23.48 ± 11.68 mL of blood samples per person was taken from the patients for diagnosis and examination. 25.3% of patients were given erythrocyte suspension due to anemia (41.4%), acute bleeding (24.1%), surgical intervention (12.1%) or hemodynamic instability (22.4%). The mean Hb values before transfusion in anemic patients were 6.9 ± 1.1 g / dL. In 15.5% of the patients (n = 9), there was a transfusion-related febrile reaction and an allergic reaction developed in one patient. There were no differences in the incidence of anemia, transfusion rates, and complications. In conclusion, it was found that, most of the patients admitted to our AICU were anemic; the decline in Hb values continued over time; repeated blood sampling contribute to the development of anemia; most frequent transfusion-related complication was the febrile reaction and it was found that our practices complied with the existing universal transfusion guidelines. Keywords: Intensive Care Unit, Anemia, Blood Transfusion