{"title":"[Treatment with blood products in the intensive care unit].","authors":"Sirak Petros","doi":"10.1007/s00063-025-01278-5","DOIUrl":null,"url":null,"abstract":"<p><p>The evidence for the administration of blood products in the critically ill is frequently meagre. It is often difficult to differentiate between adaptive changes and pathological alterations of blood components requiring treatment. Anemia is frequently observed in critically ill patients; however, there is no evidence for a benefit of a liberal transfusion strategy. Thrombocytopenia and alterations in plasmatic coagulation could correlate with an unfavorable outcome but they are not predictive regarding a substitution. Therefore, the indications for platelet transfusion and the administration of plasma or coagulation factor concentrates should always be clinically and critically evaluated. There is also no evidence for the generous use of albumin in intensive care medicine. In conclusion, a restrictive strategy is recommended for all blood products. The available evidence and a critical clinical assessment should be the mainstays of the decision for treatment with blood products.</p>","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":"438-446"},"PeriodicalIF":1.3000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00063-025-01278-5","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/7 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
The evidence for the administration of blood products in the critically ill is frequently meagre. It is often difficult to differentiate between adaptive changes and pathological alterations of blood components requiring treatment. Anemia is frequently observed in critically ill patients; however, there is no evidence for a benefit of a liberal transfusion strategy. Thrombocytopenia and alterations in plasmatic coagulation could correlate with an unfavorable outcome but they are not predictive regarding a substitution. Therefore, the indications for platelet transfusion and the administration of plasma or coagulation factor concentrates should always be clinically and critically evaluated. There is also no evidence for the generous use of albumin in intensive care medicine. In conclusion, a restrictive strategy is recommended for all blood products. The available evidence and a critical clinical assessment should be the mainstays of the decision for treatment with blood products.
期刊介绍:
Medizinische Klinik – Intensivmedizin und Notfallmedizin is an internationally respected interdisciplinary journal. It is intended for physicians, nurses, respiratory and physical therapists active in intensive care and accident/emergency units, but also for internists, anesthesiologists, surgeons, neurologists, and pediatricians with special interest in intensive care medicine.
Comprehensive reviews describe the most recent advances in the field of internal medicine with special focus on intensive care problems. Freely submitted original articles present important studies in this discipline and promote scientific exchange, while articles in the category Photo essay feature interesting cases and aim at optimizing diagnostic and therapeutic strategies. In the rubric journal club well-respected experts comment on outstanding international publications. Review articles under the rubric "Continuing Medical Education" present verified results of scientific research and their integration into daily practice. The rubrics "Nursing practice" and "Physical therapy" round out the information.