Browsing by Author "Reuland, Merijn C."

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    Association between red blood cell transfusion and adverse clinical outcomes is Independent of cardiac history: a multicenter observational InPUT study analysis
    (2025) Kimmoun, Antoine; Girerd, Nicolas; Duarte, Kevin; Bruno, Jolie; Schenk, Jimmy; Levy, Bruno; Baudry, Guillaume; Raasveld, Senta J.; de Bruin, Sanne; Reuland, Merijn C.; van den Oord, Claudia; Schaap, Caroline M.; Bakker, Jan; Cecconi, Maurizio; Feldheiser, Aarne; Meier, Jens; McQuilten, Zoe; Müller, Marcella C. A.; Scheeren, Thomas W. L.; Aubron, Cécile; Flint, Andrew W. J.; Hamid, Tarikul; Piagnerelli, Michaël; Mahečić, Tina T.; Benes, Jan; Russell, Lene; Aguirre-Bermeo, Hernan; Triantafyllopoulou, Konstantina; Chantziara, Vasiliki; Gurjar, Mohan; Myatra, Sheila N.; Pota, Vincenzo; Elhadi, Muhammed; Gawda, Ryszard; Mourisco, Mafalda; Lance, Marcus; Neskovic, Vojislava; Podbregar, Matej; Llau, Juan V.; Quintana-Diaz, Manual; Cronhjort, Maria; Pfortmueller, Carmen A.; Yapici, Nihan; Nielsen, Nathan; Shah, Akshay; de Grooth, Harm-Jan; Vlaar, Alexander P. J.; Mebazaa, Alexandre
    Purpose Red-blood-cell (RBC) transfusion is one of the most frequent interventions in critical care patients. While patients with acute cardiac conditions are more likely to receive transfusions at higher haemoglobin thresholds than other critically ill patients, data on RBC transfusion practice for critically ill patients with pre-existing cardiac conditions are scarce. Methods Using the International Point-Prevalence Study of Intensive-Care Unit Transfusion Practices cohort, weighted logistic regression investigated the association between the RBC units transfused and the primary composite outcome of 28-day mortality, new-onset acute kidney injury or ventilatory weaning failure. Interactions with cardiac history (acute coronary syndrome and/or heart failure) were tested. Results Cardiac history was present in 746 of 3643 patients (20%) and 894 of 3643 (25%) received at least one RBC unit. Transfusion rates were similar in patients with and without cardiac history (25% vs. 24%; p = 0.51). Among transfused patients, median nadir haemoglobin during ICU stay was slightly higher in those with cardiac history (7.6 g/dL vs. 7.4 g/dL respectively; p = 0.007), whereas stated haemoglobin transfusion threshold did not statistically differ (8.5 g/dL vs. 8.0 g/dL; p = 0.11). Each additional RBC unit increased the odds of the composite outcome in the whole cohort (2.18, 95% CI 1.85–2.56, p < 0.0001), without interaction with cardiac history (p = 0.44). Conclusions RBC transfusion was commonly and similarly prescribed in critically ill patients with or without cardiac history. Each additional unit was associated with a worse outcome with no evidence of differential effect due to cardiac history. Trial registration NL9049 (Dutch Trial Register), registered on 16 November 2020. Graphical Abstract
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    Red Blood Cell Transfusion in the Intensive Care Unit
    (2023) Raasveld, Senta Jorinde; de Bruin, Sanne; Reuland, Merijn C.; Van den Oord, Claudia; Schenk, Jimmy; Aubron, Cecile; Bakker, Jan; Cecconi, Maurizio; Feldheiser, Aarne; Meier, Jens; Mueller, Marcella C. A.; Scheeren, Thomas W. L.; Mcquilten, Zoe; Flint, Andrew; Hamid, Tarikul; Piagnerelli, Michael; Tomic Mahecic, Tina; Benes, Jan; Russell, Lene; Aguirre-Bermeo, Hernan; Triantafyllopoulou, Konstantina; Chantziara, Vasiliki; Gurjar, Mohan; Myatra, Sheila Nainan; Pota, Vincenzo; Elhadi, Muhammed; Gawda, Ryszard; Mourisco, Mafalda; Lance, Marcus; Neskovic, Vojislava; Podbregar, Matej; Llau, Juan V.; Quintana-Diaz, Manual; Cronhjort, Maria; Pfortmueller, Carmen A.; Yapici, Nihan; Nielsen, Nathan D.; Shah, Akshay; de Grooth, Harm-Jan; Vlaar, Alexander P. J.; InPUT Study Grp
    Importance Red blood cell (RBC) transfusion is common among patients admitted to the intensive care unit (ICU). Despite multiple randomized clinical trials of hemoglobin (Hb) thresholds for transfusion, little is known about how these thresholds are incorporated into current practice. Objective To evaluate and describe ICU RBC transfusion practices worldwide. Design, Setting, and Participants International, prospective, cohort study that involved 3643 adult patients from 233 ICUs in 30 countries on 6 continents from March 2019 to October 2022 with data collection in prespecified weeks. Exposure ICU stay. Main Outcomes and Measures The primary outcome was the occurrence of RBC transfusion during ICU stay. Additional outcomes included the indication(s) for RBC transfusion (consisting of clinical reasons and physiological triggers), the stated Hb threshold and actual measured Hb values before and after an RBC transfusion, and the number of units transfused. Results Among 3908 potentially eligible patients, 3643 were included across 233 ICUs (median of 11 patients per ICU [IQR, 5-20]) in 30 countries on 6 continents. Among the participants, the mean (SD) age was 61 (16) years, 62% were male (2267/3643), and the median Sequential Organ Failure Assessment score was 3.2 (IQR, 1.5-6.0). A total of 894 patients (25%) received 1 or more RBC transfusions during their ICU stay, with a median total of 2 units per patient (IQR, 1-4). The proportion of patients who received a transfusion ranged from 0% to 100% across centers, from 0% to 80% across countries, and from 19% to 45% across continents. Among the patients who received a transfusion, a total of 1727 RBC transfusions were administered, wherein the most common clinical indications were low Hb value (n = 1412 [81.8%]; mean [SD] lowest Hb before transfusion, 7.4 [1.2] g/dL), active bleeding (n = 479; 27.7%), and hemodynamic instability (n = 406 [23.5%]). Among the events with a stated physiological trigger, the most frequently stated triggers were hypotension (n = 728 [42.2%]), tachycardia (n = 474 [27.4%]), and increased lactate levels (n = 308 [17.8%]). The median lowest Hb level on days with an RBC transfusion ranged from 5.2 g/dL to 13.1 g/dL across centers, from 5.3 g/dL to 9.1 g/dL across countries, and from 7.2 g/dL to 8.7 g/dL across continents. Approximately 84% of ICUs administered transfusions to patients at a median Hb level greater than 7 g/dL. Conclusions and Relevance RBC transfusion was common in patients admitted to ICUs worldwide between 2019 and 2022, with high variability across centers in transfusion practices.