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Restricting blood transfusion guidelines may save both lives and money

CHEST: Blood Transfusion Practices Should Be Revisited

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Study looks at transfusion practices of intensive care providers in a typical tertiary hospital
From 1999 to 2017

Mortality Down for Autoantibody-Associated Vasculitides Patients

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Average annual decline of 1.6 percent in AAV-related mortality rate seen from 1999 to 2017 in the U.S.
Compared with placebo

No Benefit Found for High-Dose Vitamin C Infusions in Sepsis, ARDS

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No differences seen versus placebo in organ dysfunction scores, biomarkers of inflammation or vascular injury
The crude incidence of candidemia was 8.7 per 100

Crude Incidence of Candidemia 8.7 Per 100,000 in 2012 to 2016

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Incidence highest in older adults (≥65 years); higher for men than women, blacks versus nonblacks
Mortality is lower for patients with candida bloodstream infection receiving an infectious disease consultation

Infectious Disease Consultation May Lower Candida Mortality

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Mortality at 90 days lower in patients with candida bloodstream infection who receive an ID consult
When empirical antimicrobial therapy is initiated in patients with severe manifestations of sepsis

Initiating Empirical Tx for Sepsis Reduces Blood Culture Sensitivity

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12 percent difference seen in proportion of positive blood cultures before and after antimicrobial therapy
Using the true number of central lines as the denominator improves methods of determining central line-associated bloodstream infection rates

Method to Calculate Central Line Infections Flawed

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Counting multiple concurrent central lines may help account for hospitals with patients with higher acuity of care
About two-thirds of patients who survive hospitalization for sepsis have persistent elevation of inflammation and immunosuppression biomarkers

Persistent Inflammation After Sepsis Linked to Higher Mortality

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Persistent inflammation, immunosuppression linked to increased mortality and readmission after discharge
Blood transfusions received postpartum are associated with an increased risk for transfusion reactions

Transfusion Reactions Up With Postpartum Blood Transfusion

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Preeclampsia the single most important risk factor for transfusion reactions in this patient population
Individuals with low- or intermediate-risk monoclonal gammopathy of undetermined significance can experience progression to multiple myeloma within five years

MGUS Can Progress to Multiple Myeloma Within Five Years

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Risk factors associated with progression include IgA isotype, 15 g/L or more monoclonal spike