19 Oct 2023 • The 2023 AABB Red Blood Cell Transfusion recommendations were developed in collaboration with the International Society of Blood Transfusion, International Collaboration for Transfusion Medicine Guidelines, the Society of Critical Care Medicine, the European Blood Alliance, and the Society for the Advancement of Patient Blood Management. The primary objective of these guidelines, published in JAMA was to provide credible recommendations for clinicians caring for adults and children considered for RBC transfusions.

RECOMMENDATION 1

• For hospitalized adult patients who are hemodynamically stable, the international panel recommends a restrictive transfusion strategy considering transfusion when the hemoglobin concentration is less than 7 g/dL (strong recommendation, moderate certainty evidence). In accordance with the restrictive strategy threshold used in most trials, clinicians may choose a threshold of 7.5 g/dL for patients undergoing cardiac surgery and 8 g/dL for those undergoing orthopedic surgery or those with preexisting cardiovascular disease.

RECOMMENDATION 2

• For hospitalized adult patients with hematologic and oncologic disorders, the panel suggests a restrictive transfusion strategy considering transfusion when the hemoglobin concentration is less than 7 g/dL (conditional recommendations, low certainty evidence).

RECOMMENDATION 3

• For critically ill children and those at risk of critical illness who are hemodynamically stable and without a hemoglobinopathy, cyanotic cardiac condition, or severe hypoxemia, the international panel recommends a restrictive transfusion strategy considering transfusion when the hemoglobin concentration is less than 7 g/dL (strong recommendation, moderate certainty evidence).

RECOMMENDATION 4

• For hemodynamically stable children with congenital heart disease, the international panel suggests a transfusion threshold that is based on the cardiac abnormality and stage of surgical repair: 7 g/dL (biventricular repair), 9 g/dL (single-ventricle palliation), or 7 to 9 g/dL (uncorrected congenital heart disease) (conditional recommendation, low certainty evidence).

Source: JAMA | Read full story