Critical Care Focus, 8: Blood and Blood Transfusion
Helen F. Galley (ed)
BMJ Books: London, UK, 2002, 85 pp; illustrated; indexed
ISBN: 0-7279-1657-2; Price £14.95
Early on, the reader is provoked by the assertion that 'transfusion practice is a good example of how some patterns of treatment in critical care have been set prematurely without proper ... evidence'. A well-conducted prospective multicentre study (TRICC Trial) showed that mortality may be increased if the traditional transfusion practice - targeting haemoglobin of 12 g dL−1 - is followed. This sets the tone of the book, to challenge preconceptions and encourage us to question other established treatments. The book goes on to examine why blood transfusion may be hazardous, and how the risks may be modified, such as through filtration. Bleeding and clotting tendencies are discussed, and several complicated topics are covered clearly and comprehensively. A whole chapter is devoted to activated protein C, which is appropriate in view of the current high interest among intensivists. The recent multicentre study is well summarized, but perhaps some of the criticisms could have been presented. Other important subjects, including transfusion-related acute lung injury, the indications for colloids (are there any?) and blood substitutes, are presented. Overall, this volume is interesting and well conceived. I enjoyed reading it.
M. S. Avidan