January 2013 critical care journal club

Abstract

No abstract available. Article truncated at 150 words. Villanueva C, Colomo A, Bosch A, Concepción M, Hernandez-Gea V, Aracil C, Graupera I, Poca M, Alvarez-Urturi C, Gordillo J, Guarner-Argente C, Santaló M, Muñiz E, Guarner C. Transfusion strategies for acute upper gastrointestinal bleeding. N Engl J Med. 2013;368(1):11-21. The hemoglobin threshold for transfusion of red cells in patients with acute gastrointestinal bleeding is controversial. The authors compared the efficacy and safety of a restrictive transfusion strategy (transfusion when the hemoglobin level fell below 7 g per deciliter) with a liberal transfusion strategy in 921 patients with severe acute upper gastrointestinal bleeding. The probability of survival at 6 weeks was higher in the restrictive-strategy group than in the liberal-strategy group and the probability of further bleeding adverse events were lower. This article may alter practices in the ICU. Previously, many intensivists, including myself, thought it was important to make sure that we “stayed ahead” of the bleeding. This study …

Keywords

• gastrointestinal bleeding
• transfusion
• traumatic brain injury
• intracranial pressure monitoring
• ventilator associated pneumonia
• VAP
• VAP guidelines
• tele-ICU
• medical costs