The International Point Prevalence Study of Intensive Care Unit Transfusion Practices (InPUT) is a prospective cohort study that included 3643 adult patients (62% male; mean age, 61 years) from 233 intensive care units (ICUs) (median of 11 patients per ICU) across six continents in 30 countries. The study was designed to assess global transfusion practices in the ICU. In total, 25% (894/2643) of patients received at least one RBC transfusion in the ICU with a mean of two RBC units transfused per patient, which was similar to another worldwide study published over a decade ago. The proportion of patients transfused ranged from 0% to 100% of patients across centers, from 0% to 80% across countries, and from 19% to 45% across continents. Across all continents, a low hemoglobin level was the most common reason stated for RBC transfusion (82%; mean Hb before transfusion, 7.4 g/dL) followed by active bleeding (28%) and hemodynamic instability (24%). Most transfusion events were also triggered by one or more physiological conditions (i.e., non-Hb)—most commonly hypotension, tachycardia, or increased lactate levels. Overall, this study found considerable variation between individual centers, but the reasons for the variability require further inquiry.
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