La transfusión de concentrados de hematíes en pacientes críticos de una uci polivalente de argentina
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Palabras clave

Transfusión de sangre
hematíes
cuidados intensivos
mortalidad
pronóstico

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1.
Gattino SP, Rocchetti N, Karantzias J, Bagilet D, Settecase C, Quaglino M. La transfusión de concentrados de hematíes en pacientes críticos de una uci polivalente de argentina. Rev Arg de Ter Int. [Internet]. 26 de enero de 2022 [citado 22 de septiembre de 2023];39. Disponible en: https://revista.sati.org.ar/index.php/MI/article/view/792

Resumen

OBJETIVO: evaluar si la transfusión de concentrados de hematíes (CH) en el paciente crítico en nuestra Unidad de Cuidados Intensivos (UCI) se asocia a mayor mortalidad.

DISEÑO: Estudio retrospectivo y observacional realizado desde enero de 2009 a diciembre de 2018.

ÁMBITO: UCI polivalente.

PACIENTES: Mayores de 18 años, internados al menos durante 24 horas.

INTERVENCIONES: Ninguna.

VARIABLES DE INTERÉS: Número de transfusiones de CH y mortalidad en UCI.

RESULTADOS: Se analizaron 4244 pacientes que reunieron los datos requeridos. Edad promedio: 50,35 (±17,14) años, varones: 64,6%, días de internación: 6,61 (±8,94), APACHE II 14,74 (±8,67), SAPS II 36,87 (±19,40), SOFA 4,96 (±3,72), necesidad de VM: 46,9% y mortalidad 24,6%. Requirieron transfusiones de CH 735 (17,3%). Cuando se compararon éstos con los no transfundidos se pudo apreciar que los primeros presentaron menor edad (51 vs. 53  años, p<0,001), puntajes de gravedad más elevados (APACHE II 17 vs. 13 p<0,001; SAPS II 40 vs. 32 p<0,001; SOFA 6 vs. 4 p<0,001), mayor estancia en UCI (6 vs. 3 días, p<0,001), necesidad de VM (65,7 vs. 42,9%, p<0,001) y mortalidad (34vs. 22,6%, <0,001). El análisis de regresión logística multivariante mostró que los pacientes con mayor número de CH transfundidos presentaron mayor mortalidad en UCI [odds ratio de 1,066 (IC 95%: 1,015-1,119; p 0,01)], ajustando por edad, días de internación, escalas de gravedad y necesidad de VM.

CONCLUSIONES: A partir de estos resultados podemos concluir que la transfusión de CH en pacientes críticos se asoció con una mayor mortalidad en nuestra UCI.

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Citas

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