Role of central venous oxygen saturation in restrictive transfusion strategy in Intensive Care Unit

The decision whether to transfuse an anemic patient is a considerable challenge in the intensive care unit (ICU). Transfusions are associated with well-described risks, including transfusion-transmitted infections, transfusion-related acute lung injury, transfusion-associated circulatory overload, and acquired immunosuppression. This study was done to evaluate if central venous oxygen saturation (Svo2) guided transfusion could reduce transfusion incidence in ICU patients. This prospective observational study included 80 adult patients admitted consecutively to ICU and were randomly divided into two groups, case group (n=40) that included patients who had transfusion according to the restrictive central Svo2–guided protocol and control group (n=40) that included patients who had transfusion according to HB. There was no statistically significant difference between the two study groups regarding the requirement of blood transfusion during follow-up. The requirement for transfusion was higher in the control group, but it didn’t reach a statistically significant level, the haemoglobin level showed a statistically significant increase in the two study groups along the duration of follow up. The ScvO2 showed initial decrease in the two study groups followed by increase till fifth reading that showed decrease again. There was a decrease in the requirement of transfusion in both groups along the duration of follow up. The length of hospital stay, requirement for mechanical ventilation and the mortality were higher in the control group, but it didn’t reach a statistically significant level. This study supported the hypothesis that transfusion therapy should be individualized according to the oxygen reserve of the patient.