Bülent Kaya, Sezer Yakupoğlu, Elif Bombacı, Nur Benzonana, Gaye Filinte, Recep Demirhan
Southern Clinics of Istanbul Eurasia - 2025;36(3):205-212
Objective: In patients admitted to burn intensive care units (ICUs), increase the need for blood transfusions. In parallel with prolonged ICU stays, the risk of bloodstream infections (BSIs) also increases. This study aims to examine the relationship between transfusion and BSIs and to promote the practice of restrictive transfusion. Methods: 158 patients with severe burns (>=20% total body surface area) were treated in the burn ICU of our hospital over five years. The hemoglobin (Hb) threshold for restrictive transfusion was defined as 7 g/dL, while for liberal transfusion it was set at 10 g/dL. Results: Of the 158 patients included in the study, 17.7% (n=28) were female. The mean age of the patients was 41+/-15 years. The average total body surface area (TBSA) burned was 42.7+/-17% (range: 20-92%). The causes of burns were flame in 79.2% (n=125), electricity in 10.1% (n=16), boiling water in 7% (n=11), hot oil and steam in one patient each (0.6%), and chemicals in 2.5% (n=4). A statistically significant relationship was found between the total number of transfusions and burn percentage, length of stay in the burn ICU, number of escharotomy procedures performed, final hemoglobin (Hb), white blood cell (WBC) count, and number of fresh frozen plasma (FFP) units (p<0.05). Restrictive transfusion was adopted in 72.5-86.8% of erythrocyte suspension (ES) transfusions. Among the BSIs, the most commonly isolated pathogens were coagulase-negative staphylococci (CNS) in 28.5% (n=45), A. baumannii in 19.6% (n=31), and P. aeruginosa in 12.7% (n=20). A statistically significant association was found between the number of transfusions and the presence of CNS and P. aeruginosa isolates (p<0.05), whereas no such association was found with A. baumannii (p>0.05). The rate of BSIs caused by Candida species was 4.5% (n=7). Conclusion: We recommend a restrictive transfusion strategy in burn ICU patients to minimize transfusion-related reactions and BSI risk while ensuring optimal patient support.
