A survey of physicians' attitudes to transfusion practice in critically ill patients in the UK

Abstract

SummaryThis study aimed to examine the attitudes of intensivists and haematologists to the use of blood and blood products using a scenario-based postal questionnaire. One hundred and sixty-two intensivists and 77 haematologists responded to the survey. In four scenarios, the baseline haemoglobin thresholds for red cell transfusion ranged from 6 to 12 g.dl )1. There was significant variation between scenarios (p < 0.005). Increasing age, high Acute Physiology and Chronic Health Status II score, surgery, acute respiratory distress syndrome, septic shock and lactic acidosis significantly (p < 0.005) modified the transfusion threshold. There were greater variations in the baseline threshold for platelet transfusion. The majority of respondents (72.3%) selected a baseline haemoglobin threshold between 9 and 10 g.dl )1 . The thresholds for platelet transfusion were far less consistent.

Anemia and blood transfusion practices in the critically ill: A prospective cohort review

“…8,9 Therefore, blood should be transfused considering factors such as age, disease severity, and specific diagnoses. 6,7,10,11 Yet in a United Kingdom survey of transfusion practices with the critically ill, Boralessa et al 12 reported RBC transfusion triggers of 9 to 10 mg/dL. Another survey of European ICU transfusion practices found that the mean pretransfusion hemoglobin level of patients not actively bleeding was 8.5 mg/dL.…”

Revisiting transfusion practices in critically ill patients*

“…Surveys of transfusion practices have repeatedly documented the importance attributed to hemoglobin triggers. A survey conducted by Boralessa and colleagues (2) in 1998 using a modified version of the Canadian survey found that 72% of British respondents opted for a transfusion threshold between 90 and 100 g/L, and 96% stated that they would transfuse at least 2 RBC units. These authors documented that transfusion practice among British critical care physicians was similar to observations made 7 yrs earlier among Canadian physicians.…”

Blood use in patients receiving intensive chemotherapy for acute leukemia or hematopoietic stem cell transplantation: the impact of a health system–wide patient blood management program

“…Changing this ingrained practice pattern has proved difficult. More recent studies have shown little change in the attitude of physicians with less than 10% of intensivists and no hematologists considering single‐unit transfusions in various clinical scenarios …”