Blood Transfusion and Its Components




E. Celis-Rodriguez, K. Reinhart, Y. Sakr
Introduction

tRANSFUSSION
Transfusion of blood products in the critical care setting is a common practice that has been performed for many years. Since the 19th century, when James Blundell reported the clinical application of the treatment of hemorrhage for the first time in the Lancet [1], blood transfusion has been the cornerstone in the treatment of severe hemorrhage, not only as a means of improving oxygen transport capacity, but also to maintain homeostasis and reduce mortality rates [1]. The 10/30 rule was the standard of care for decades [2], but the first report of this appeared in the 1940s, when Lundy et al. [3] stated that “It is a clever idea to provide blood before surgery,” referring to patients whose hemoglobin levels were between 8 and 10 g/dL. With the more restrictive use of blood transfusion since the 1980s, there have been attempts to define specific indications for transfusion, minimal hemoglobin levels for critically ill patients, and the benefits and potential risks of transfusion [4].

The Neuroendocrine Response to Sepsis


Introduction
Acute response to LPS includes the release of a number of proinflammatory mediators that reach the brain in areas free of blood-brain barrier, or via specific transport systems. The hypothalamic-pituitary axis is also activated via neural routes. Then, infection is characterized by high circulating levels of adrenocorticotrope hormone (ACTH), and cortisol which remain in plateau as long as the stressful condition is maintained. Circulating vasopressin levels follow a biphasic response with high concentrations, followed by relative vasopressin insufficiency in about one third of cases.

PULMONARY

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CARDIOLOGY

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FALL

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