• Brian M Fuller, Mithil Gajera, Christa Schorr, David Gerber, R Phillip Dellinger, Joseph Parrillo, and Sergio Zanotti.
• Department of Anesthesiology, Division of Critical Care Medicine, and the Division of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA.
• Indian J Crit Care Med. 2010 Oct 1;14(4):165-9.

BackgroundThe optimal hemoglobin level and transfusion threshold in patients with septic shock treated with an early, goal oriented approach to resuscitation remains unknown.AimsTo assess the impact of packed red blood cell (PRBC) transfusion on clinically relevant outcomes in patients with septic shock treated with early goal directed therapy (EGDT).Settings And DesignRetrospective cohort study of 93 patients who presented with septic shock, to a single center academic intensive care unit and received EGDT.Materials And MethodsData were collected on patients identified via the Surviving Sepsis Campaign Chart Review database and linked to Project IMPACT database. The PRBC group and no PRBC group were compared by the Pearson chi-square and Fisher's exact test to analyze statistical significance.ResultsThe PRBC group had a mortality of 41.2% vs. 33.9% in the no PRBC transfusion group (P = NS). The PRBC group also had more mechanical ventilation days (11.2 days vs. 5.0 days, (P ≤ 0.05), longer hospital length of stay (25.9 days vs. 12.5 days, (P ≤ 0.05), and longer intensive care unit length of stay (11.4 days vs. 3.8 days, (P ≤ 0.05).ConclusionsIn this retrospective cohort study, transfusion of PRBCs was associated with worsened clinical outcomes in patients with septic shock treated with EGDT. Further studies are needed to determine the impact of transfusion of PRBC within the context of early resuscitation of patients with septic shock, as the beneficial effects gained by an early and goal oriented approach to resuscitation may be lost by the negative effects associated with PRBC transfusion.

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