Effect of RBC Transfusion on Sublingual Microcirculation in Hemorrhagic Shock Patients: A Pilot Study

Objectives: The effects of RBC transfusion on microvascular perfusion are not well documented. We investigated the effect of RBC transfusion on sublingual microcirculation in hemorrhagic shock patients. Design: Prospective, preliminary observational study. Settings: A 28-bed, surgical ICU in a university hospital. Patients: Fifteen hemorrhagic shock patients requiring RBC transfusion. Intervention: Transfusion of one unit of RBCs. Measurements and Main Results: The sublingual microcirculation was assessed with a Sidestream Dark Field imaging device before and after RBC transfusion. After transfusion of one unit of RBC, hemoglobin concentration increased from 8.5 g/dL (7.6–9.5 g/dL) to 9.6 g/dL (9.1–10.3 g/dL) g/dL (p = 0.02) but no effect on macrocirculatory parameters (arterial pressure, cardiac index, heart rate, and pulse pressure variations) was observed. Transfusion of RBC significantly increased microcirculatory flow index (from 2.3 [1.6–2.5] to 2.7 [2.6–2.9]; p

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