Appropriateness of Allogeneic Red Blood Cell Transfusion: The International Consensus Conference on Transfusion Outcomes

Shander, Aryeh; Fink, Arlène; Javidroozi, Mazyar; Erhard, J; Farmer, Shannon; Corwin, Howard L.; Goodnough, Lawrence T.; Hofmann, Axel; Isbister, James P.; Ozawa, Sherri; Spahn, Donat R.

doi:10.1016/j.tmrv.2011.02.001

Cited by 184 publications

(133 citation statements)

References 49 publications

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“…56 -58 Despite the risks, limited benefits, costs, and scarcity, a substantial proportion of RBC transfusions given today may not be appropriate or justified according to the report of the ICCTO panel and several reports on variable transfusion practices in otherwise comparable populations. 53 These findings support a more cautious transfusion strategy than the current system. A retrospective study in two US hospitals found a significant correlation between inadequate or suboptimal documentation and failure to justify transfusion, with 73% of inadequately documented transfusions not meeting hospital guidelines.…”

Section: Transfusion and Preoperative Anaemiamentioning

confidence: 76%

Patient Blood Management in Europe

Shander¹,

Aken²,

Gombotz³

et al. 2013

Survey of Anesthesiology

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Section: Transfusion and Preoperative Anaemiamentioning

confidence: 76%

Patient Blood Management in Europe

Shander¹,

Aken²,

Gombotz³

et al. 2013

Survey of Anesthesiology

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“…In light of available evidence, a consensus multidisciplinary panel has concluded that allogeneic red blood cell transfusions are unlikely (or uncertain) to improve patients' outcomes in the vast majority of clinical scenarios in which transfusions are commonly used, when patients' hemoglobin level is ≥8 g/dL. 24 Whenever possible, physiologic indicators of tissue oxygen delivery and ischemia should be used in guiding transfusion decisions. 17,25 This is a field of ongoing research, and new devices for (preferably noninvasive) continuous monitoring of hemoglobin…”

Section: Indication Of Transfusionmentioning

confidence: 99%

From Bloodless Surgery to Patient Blood Management

Shander

Javidroozi

Perelman

et al. 2012

Mount Sinai J Medicine

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Safety and efficacy concerns of allogeneic blood transfusions and their impact on patient outcomes and associated staggering costs and restricted supply have fueled the quest for other modalities and strategies to reduce use of blood components. Patient blood management focuses on multidisciplinary and multimodal preventive measures to reduce or obviate the need for transfusions and ultimately to improve the clinical outcomes of patients. Patient blood management strategies can be applied at every stage of care to surgical and nonsurgical patients, and they Address

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“…It is well known that allogeneic transfusions induce immune suppression and are an independent predictor of morbidity and mortality [142][143][144]. The effect of "anesthetic techniques and perioperative management" on positively influencing the balance between inflammation and immune competence is an intriguing avenue for future study.…”

Section: Resultsmentioning

confidence: 99%

Blood Loss and Massive Transfusion in Patients Undergoing Major Oncological Surgery: What Do We Know?

Cata

Gottumukkala

2012

ISRN Anesthesiology

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Patients with solid malignancies who were not candidates for tumor resections in the past are now presenting for extensive oncological resections. Cancer patients are at risk for thromboembolic complications due to an underlying hypercoagulable state; however, some patients may have an increased risk for bleeding due to the effects of chemotherapy, the administration of anticoagulant drugs, tumor-related fibrinolysis, tumor location, tumor vascularity, and extent of disease. A common potential complication of all complex oncological surgeries is massive intra-and postoperative hemorrhage and the subsequent risk for massive blood transfusion. This can be anticipated or unexpected. Several surgical and anesthesia interventions including preoperative tumor embolization, major vessel occlusion, hemodynamic manipulation, and perioperative antifibrinolytic therapy have been used to prevent or control blood loss with varying success. The exact incidence of massive blood transfusion in oncological surgery is largely unknown and/or underreported. The current literature mostly consists of purely descriptive observational studies. Thus, recommendation regarding specific perioperative intervention cannot be made at this point, and more research is warranted.

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Appropriateness of Allogeneic Red Blood Cell Transfusion: The International Consensus Conference on Transfusion Outcomes

Cited by 184 publications

References 49 publications

Patient Blood Management in Europe

Patient Blood Management in Europe

From Bloodless Surgery to Patient Blood Management

Blood Loss and Massive Transfusion in Patients Undergoing Major Oncological Surgery: What Do We Know?

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