Evidence map›Paper›PMID 42541477›Full record

ArticleTransfusion2026

Transfusion intensity in the ICU: Reasons and triggers.

Merijn C Reuland, Senta J Raasveld, Jimmy Schenk, Claudia van den Oord, Sanne de Bruin, Caroline M Schaap, Andrew W J Flint, Jan Bakker, Maurizio Cecconi, Aarne Feldheiser and 32 more

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Article in Transfusion, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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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

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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

42 authors.

Merijn C ReulandDepartment of Intensive Care, Amsterdam University Medical Center, Amsterdam, The Netherlands.ORCID https://orcid.org/0009-0009-3738-0397
Senta J RaasveldDepartment of Intensive Care, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Jimmy SchenkDepartment of Intensive Care, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Claudia van den OordDepartment of Intensive Care, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Sanne de BruinDepartment of Intensive Care, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Caroline M SchaapDepartment of Intensive Care, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Andrew W J FlintSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Jan BakkerDepartment of Intensive Care Adults, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Maurizio CecconiDepartment of Anesthesiology and Intensive Care, IRCCS Humanitas Research Hospital, Milan, Italy.
Aarne FeldheiserDepartment of Anaesthesiology, Intensive Care Medicine and Pain Therapy, EvangKliniken Essen-Mitte, Essen, Germany.ORCID https://orcid.org/0000-0002-0014-8879
Jens MeierDepartment of Anesthesiology and Intensive Care, Kepler University Clinic, Linz, Austria.
Thomas W L ScheerenDepartment of Anesthesiology, University Medical Center Groningen, Groningen, The Netherlands.
Tarikul HamidDepartment of Critical Care, Asgar Ali Hospital, Dhaka, Bangladesh.
Michaël PiagnerelliDepartment of Intensive Care, CHU Charleroi Marie Curie, Charleroi, Belgium.
Tina Tomić MahečićDepartment of Anesthesiology and Intensive Care, University Clinical Hospital Center Zagreb, Zagreb, Croatia.ORCID https://orcid.org/0000-0003-2470-6238
Jan BenesDepartment of Anesthesiology and Intensive Care Medicine, University Hospital Plzen, Plzen, Czech Republic.
Lene RussellDepartment of Intensive Care, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.ORCID https://orcid.org/0000-0001-7352-8728
Hernan Aguirre-BermeoUnidad de Cuidados Intensivos, Hospital Vicente Corral Moscoso, Cuenca, Ecuador.
Konstantina TriantafyllopoulouDepartment of Cardiothoracic Surgery, European Interbalkan Medical Center, Thessaloniki, Greece.
Vasiliki ChantziaraIntensive Care Unit, Sotiria Chest Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Mohan GurjarDepartment of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.ORCID https://orcid.org/0000-0002-8489-0324
Sheila Nainan MyatraDepartment of Anesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India.
Vincenzo PotaDepartment of Child, General and Specialistic Surgery, University of Campania Luigi Vanvitelli, Naples, Italy.ORCID https://orcid.org/0000-0001-9999-3388
Muhammed ElhadiFaculty of Medicine, University of Tripoli, Tripoli, Libya.
Ryszard GawdaDepartment of Anesthesiology and Intensive Care, University of Opole, Opole, Poland.ORCID https://orcid.org/0000-0001-6060-0751
Mafalda MouriscoDepartment of Intensive Care, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal.
Marcus LanceDepartment of Anesthesiology, Aga Khan University Hospital, Nairobi, Kenya.
Vojislava NeskovicClinik of Anesthesiology and Critical Care, Military Medical Academy, Faculty of MMA, Belgrade, Serbia.
Matej PodbregarDepartment for Internal Intensive Care, General Hospital Celje, Celje, Slovenia.
Juan V LlauDepartment of Anesthesiology and Post-surgical Critical Care, University Hospital Doctor Peset, Valencia, Spain.ORCID https://orcid.org/0000-0002-9322-5959
Manuel Quintana-DiazIntensive Care Service, Hospital Universitario La Paz, Madrid, Spain.
Maria CronhjortDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.ORCID https://orcid.org/0000-0002-0444-8553
Carmen A PfortmuellerDepartment of Intensive Care, Inselspital, Bern University Hospital, Bern, Switzerland.
Nihan YapiciDepartment of Anesthesiology and Reanimation, University of Health Sciences, Dr. Siyami Ersek Cardiovascular Surgery Center, Istanbul, Turkey.
Nathan D NielsenDivision of Pulmonary, Critical Care and Sleep Medicine, University of New Mexico, Albuquerque, New Mexico, USA.
Akshay ShahNuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
Harm-Jan de GroothDepartment of Intensive Care, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Zoe McQuiltenSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.ORCID https://orcid.org/0000-0001-9698-7185
Cécile AubronMédecine Intensive Réanimation, CHU de Brest, Brest, France.
Alexander P J VlaarDepartment of Intensive Care, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Marcella C A MüllerDepartment of Intensive Care, Amsterdam University Medical Center, Amsterdam, The Netherlands.
InPUT Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe reasons and physiological triggers for blood transfusion in critically ill patients are not well characterized. Beyond hemoglobin levels, hemodynamic instability is frequently cited, but its role across clinical contexts remains unclear.

aims(1) To determine whether reasons and triggers for RBC transfusion differ across intensive care unit (ICU) days with varying transfusion intensity. (2) To describe reasons for non-RBC transfusions across these intensity groups.

methodsThis sub-study of the prospective International Point Prevalence Study of Intensive Care Unit Transfusion Practices (InPUT) classified ICU days by transfusion intensity: nonmajor (1 RBC unit), major (≥2 units), and massive (≥6 units in a single event, ≥10 per day, or Massive Transfusion Protocol activation). ICU days without transfusion for active bleeding were classified as no bleeding.

resultsSignificant differences in the multivariate composition of reasons for RBC transfusion were observed across intensity groups on permutational analysis of variance (PERMANOVA). Hypotension was the most frequently cited physiological trigger in nonmajor (54%, n = 80/148) and major transfusions (68%, n = 196/288), but less frequent in massive transfusions (30%, n = 14/64). Tachycardia was the second most common trigger in nonmajor (37%, n = 80/148), major (40%, n = 116/288), and massive transfusions (22%, n = 19/64).

conclusionRBC transfusions are administered for distinct, intensity-dependent combinations of reasons and triggers. Transfusion intensity and clinical context are therefore key factors in evaluating transfusion practices. Among bleeding critically ill patients, hypotension and tachycardia are the most frequently cited physiological triggers.

Indexed as

Blood TransfusionErythrocyte TransfusionIntensive Care UnitsAgedCritical IllnessFemaleHemorrhageHumansHypotensionMaleMiddle AgedProspective StudiesTachycardiableedingcritical caremassive transfusionreasons for transfusiontransfusion intensitytransfusion policy

Identifiers

PMID42541477

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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.