Critical Care Alert – March 1, 2018

March 1, 2018

• Implementing Restrictive Transfusion Strategies to Improve Patient Outcomes

  There is extensive evidence supporting a restrictive transfusion approach in critically ill patients and cardiac surgery patients. The data favor restrictive strategies in hip and knee surgery, except in geriatric patients for whom evidence favors a more liberal transfusion strategy. Evidence is sparse in sepsis, oncology, and acute coronary syndrome patients, warranting further study.

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• Massive Transfusion Protocols: Recommendations Regarding Initiation and Termination

  This was a narrative review of societal recommendations for initiation of massive transfusion protocols based on objective scoring systems and clinical assessment and criteria for termination of protocols.

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• Pre-existing Health Determines Quality of Life, Physical Symptoms After ICU Discharge

  The authors of this nested cohort study within a randomized, controlled trial of ICU survivors requiring > 48 hours of mechanical ventilation found that pre-existing comorbidity was the main determinant of long-term health-related quality of life.

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