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Blood transfusions in septic shock: is 7.0g/dL really the appropriate threshold?

Overview of attention for article published in Revista Brasileira de Terapia Intensiva, January 2015
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Title
Blood transfusions in septic shock: is 7.0g/dL really the appropriate threshold?
Published in
Revista Brasileira de Terapia Intensiva, January 2015
DOI 10.5935/0103-507x.20150007
Pubmed ID
Authors

Bruno Franco Mazza, Flavio Geraldo Rezende Freitas, Melca Maria Oliveira Barros, Luciano Cesar Pontes Azevedo, Flavia Ribeiro Machado

Abstract

To evaluate the immediate effects of red blood cell transfusion on central venous oxygen saturation and lactate levels in septic shock patients with different transfusion triggers. We included patients with a diagnosis of septic shock within the last 48 hours and hemoglobin levels below 9.0g/dL Patients were randomized for immediate transfusion with hemoglobin concentrations maintained above 9.0g/dL (Group Hb9) or to withhold transfusion unless hemoglobin felt bellow 7.0g/dL (Group Hb7). Hemoglobin, lactate, central venous oxygen saturation levels were determined before and one hour after each transfusion. We included 46 patients and 74 transfusions. Patients in Group Hb7 had a significant reduction in median lactate from 2.44 (2.00 - 3.22) mMol/L to 2.21 (1.80 - 2.79) mMol/L, p = 0.005, which was not observed in Group Hb9 [1.90 (1.80 - 2.65) mMol/L to 2.00 (1.70 - 2.41) mMol/L, p = 0.23]. Central venous oxygen saturation levels increased in Group Hb7 [68.0 (64.0 - 72.0)% to 72.0 (69.0 - 75.0)%, p < 0.0001] but not in Group Hb9 [72.0 (69.0 - 74.0)% to 72.0 (71.0 - 73.0)%, p = 0.98]. Patients with elevated lactate or central venous oxygen saturation < 70% at baseline had a significant increase in these variables, regardless of baseline hemoglobin levels. Patients with normal values did not show a decrease in either group. Red blood cell transfusion increased central venous oxygen saturation and decreased lactate levels in patients with hypoperfusion regardless of their baseline hemoglobin levels. Transfusion did not appear to impair these variables in patients without hypoperfusion. ClinicalTrials.gov NCT01611753.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 33 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Colombia 1 3%
Brazil 1 3%
Unknown 31 94%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 4 12%
Student > Master 4 12%
Other 3 9%
Researcher 3 9%
Student > Postgraduate 3 9%
Other 8 24%
Unknown 8 24%
Readers by discipline Count As %
Medicine and Dentistry 20 61%
Agricultural and Biological Sciences 2 6%
Nursing and Health Professions 1 3%
Sports and Recreations 1 3%
Pharmacology, Toxicology and Pharmaceutical Science 1 3%
Other 0 0%
Unknown 8 24%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 13 September 2015.
All research outputs
#4,446,601
of 6,336,855 outputs
Outputs from Revista Brasileira de Terapia Intensiva
#53
of 118 outputs
Outputs of similar age
#125,162
of 195,356 outputs
Outputs of similar age from Revista Brasileira de Terapia Intensiva
#3
of 5 outputs
Altmetric has tracked 6,336,855 research outputs across all sources so far. This one is in the 26th percentile – i.e., 26% of other outputs scored the same or lower than it.
So far Altmetric has tracked 118 research outputs from this source. They receive a mean Attention Score of 1.1. This one is in the 48th percentile – i.e., 48% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 195,356 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 31st percentile – i.e., 31% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 5 others from the same source and published within six weeks on either side of this one. This one has scored higher than 2 of them.