Evidence map›Paper›PMID 28608137›Full record

ArticleAnnals of intensive care2017

Red blood cell transfusion in the resuscitation of septic patients with hematological malignancies.

Adrien Mirouse, Matthieu Resche-Rigon, Virginie Lemiale, Djamel Mokart, Achille Kouatchet, Julien Mayaux, François Vincent, Martine Nyunga, Fabrice Bruneel, Antoine Rabbat and 11 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of intensive care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.1field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 18 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors at 11 institutions in 2 countries.

Adrien MirouseRéanimation médicale, hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP) and Université Paris Descartes, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France.
Matthieu Resche-RigonDépartement de biostatistiques, Hôpital Saint-Louis, AP-HP and Université Paris Diderot, Paris, France.
Virginie LemialeRéanimation médicale, Hôpital Saint-Louis, AP-HP and Université Paris Diderot, Paris, France.
Djamel MokartDépartement d'anesthésie-réanimation, Institut Paoli-Calmettes, Marseille, France.
Achille KouatchetRéanimation médicale et médecine hyperbare, CHU d'Angers, Angers, France.
Julien MayauxRéanimation médicale, Hôpital de la Pitié-Salpêtrière, AP-HP and Université Pierre et Marie Curie, Paris, France.
François VincentRéanimation polyvalente, Centre Hospitalier Intercommunal, Montfermeil, France.
Martine NyungaCentre Hospitalier de Roubaix, Roubaix, France.
Fabrice BruneelRéanimation polyvalente, Hôpital André Mignot, Le Chesnay, France.
Antoine RabbatUnité de soins intensifs respiratoires, Hôpital Cochin, AP-HP and Université Paris Descartes, Paris, France.
Christine LebertRéanimation polyvalente, Centre Hospitalier Départemental, La Roche-sur-Yon, France.
Pierre PerezRéanimation médicale, Hôpital Brabois, Nancy, France.
Anne RenaultRéanimation médicale, Centre Hospitalier de Brest, Brest, France.
Anne-Pascale MeertService des soins intensifs et urgences oncologiques, Institut Jules Bordet, Brussels, Belgium.
Dominique BenoitGhent University Hospital, Ghent, Belgium.
Rebecca HamidfarRéanimation médicale, CHU Grenoble-Alpes, Grenoble, France.
Mercé JourdainUniversité de Lille and Réanimation Polyvalente, CHU de Lille, Lille, France.
Michaël DarmonRéanimation médicale, Centre Hospitalier de Saint-Etienne, Saint-Etienne, France.
Elie AzoulayRéanimation médicale, Hôpital Saint-Louis, AP-HP and Université Paris Diderot, Paris, France.
Frédéric PèneRéanimation médicale, hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP) and Université Paris Descartes, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France. frederic.pene@aphp.fr.
Groupe de Recherche sur la Réanimation Respiratoire en Onco-Hématologie (Grrr-OH)
Délégation Paris 7 · FRCentre Hospitalier de Roubaix · FRCentre Hospitalier Régional et Universitaire de Nancy · FRDélégation Paris 5 · FRSorbonne Université · FRUniversité de Lille · FRUniversité Paris Cité · FRCentre Hospitalier Universitaire d'Angers · FRCentre Hospitalier Universitaire de Grenoble · FRGhent University Hospital · BEInstitut Jules Bordet · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIndications for red blood cell (RBC) transfusion in septic acute circulatory failure remain unclear. We addressed the practices and the prognostic impact of RBC transfusion in the early resuscitation of severe sepsis and septic shock in patients with hematological malignancies.

methodsWe performed a retrospective analysis of a prospectively collected database of patients with hematological malignancies who required intensive care unit (ICU) admission in 2010-2011. Patients with a main admission diagnosis of severe sepsis or septic shock were included in the present study. We assessed RBC transfusion during the first two days as part of initial resuscitation.

resultsAmong the 1011 patients of the primary cohort, 631 (62.4%) were admitted to the ICU for severe sepsis (55%) or septic shock (45%). Among them, 210 (33.3%) patients received a median of 2 [interquartile 1-3] packed red cells during the first 48 h. Hemoglobin levels were lower in transfused patients at days 1 and 2 and became similar to those of non-transfused patients at day 3. Early RBC transfusion was more likely in patients with myeloid neoplasms and neutropenia. Transfused patients displayed more severe presentations as assessed by higher admission SOFA scores and blood lactate levels and the further requirements for organ failure supports. RBC transfusion within the first two days was associated with higher day 7 (20.5 vs. 13.3%, p = 0.02), in-ICU (39 vs. 25.2%, p < 0.001) and in-hospital (51 vs. 36.6%, p < 0.001) mortality rates. RBC transfusion remained independently associated with increased in-hospital mortality in multivariate logistic regression (OR 1.52 [1.03-2.26], p = 0.03) and propensity score-adjusted (OR 1.64 [1.05-2.57], p = 0.03) analysis.

conclusionsRBC transfusion is commonly used in the early resuscitation of septic patients with hematological malignancies. Although it was preferentially provided to the most severe patients, we found it possibly associated with an increased risk of death.

Indexed as

AnemiaHematological malignancyRed blood cell transfusionSeptic shockSevere sepsis

Identifiers

PMID28608137
PMCPMC5468360
OpenAlexW2626472700

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.