• Edwige Péju, Jean-François Llitjos, Julien Charpentier, Anne François, Nathalie Marin, Alain Cariou, Jean-Daniel Chiche, Jean-Paul Mira, Jérôme Lambert, Matthieu Jamme, and Frédéric Pène.
• Service de médecine intensive-réanimation, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris AP-HP.Centre, Paris, France.
• Crit. Care Med. 2021 Jun 1; 49 (6): 912922912-922.

ObjectivesTransfusions of blood products are common in critically ill patients and have a potential for immunomodulation. The aim of this study is to address the impact of transfusion of blood products on the susceptibility to ICU-acquired infections in the high-risk patients with septic shock.DesignA single-center retrospective study over a 10-year period (2008-2017).SettingA medical ICU of a tertiary-care center.PatientsAll consecutive patients diagnosed for septic shock within the first 48 hours of ICU admission were included. Patients who were discharged or died within the first 48 hours were excluded.InterventionsRBC, platelet, and fresh frozen plasma transfusions collected up to 24 hours prior to the onset of ICU-acquired infection.Measurements And Main ResultsDuring the study period, 1,152 patients were admitted for septic shock, with 893 patients remaining alive in the ICU after 48 hours of management. A first episode of ICU-acquired infection occurred in 28.3% of the 48-hour survivors, with a predominance of pulmonary infections (57%). Patients with ICU-acquired infections were more likely to have received RBC, platelet, and fresh frozen plasma transfusions. In a multivariate Cox cause-specific analysis, transfusions of platelets (cause-specific hazard ratio = 1.55 [1.09-2.20]; p = 0.01) and fresh frozen plasma (cause-specific hazard ratio = 1.38 [0.98-1.92]; p = 0.05) were independently associated with the further occurrence of ICU-acquired infections.ConclusionsTransfusions of platelets and fresh frozen plasma account for risk factors of ICU-acquired infections in patients recovering from septic shock. The occurrence of ICU-acquired infections should be considered as a relevant endpoint in future studies addressing the indications of transfusions in critically ill patients.Copyright © 2021 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

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