Impact of More Restrictive Blood Transfusion Strategies on Clinical Outcomes: A Meta-analysis and Systematic Review

Salpeter, Shelley R.; Buckley, Jacob S.; Chatterjee, Saurav

doi:10.1016/j.amjmed.2013.09.017

Cited by 225 publications

(203 citation statements)

References 62 publications

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“…Normovolemic patients were shown to tolerate Hb concentrations between 5 and 6 g/dL. 3 Regardless of the cause of anemia (decreased production of red blood cells, hemolysis or bleeding), 4 the goal of transfusion is to normalize the transport of oxygen 2 and, therefore, the transfusion trigger has different values in different situations, ranging from Hb 7 g/dL in clinically stable children, [5][6][7][8] with acute bleeding 9 and sepsis but no shock; 10 to 7-8 g/dL in the postsurgical period, [11][12][13][14] and 10 g/dL in case of severe sepsis or septic shock. 15,16 Despite this knowledge, several services still adopt different transfusion protocols even for patients in similar clinical contexts, so that higher triggers relate to a greater frequency of transfusion reactions.…”

Section: Introductionmentioning

confidence: 99%

Assessment of the prescription of red blood cell concentrates in the pediatric age group

Faria

Victorino²,

Souza

et al. 2018

Rev. Assoc. Med. Bras.

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Objective: To verify the adequacy of red blood cell (RBC) prescription to pediatric patients in different sectors of a pediatric hospital. Method: A retrospective study was conducted including 837/990 RBC transfusion requisition forms for children and adolescents (0 to 13 years old) filed in between January 2007 and April 2015 by the pediatricians of the emergency room (ER), infirmary ward and intensive care unit (pICU). Transfusion requisition forms belonging to patients with chronic anemia or acute hemorrhage, as well as incompletes requisition forms, were excluded. Results: Trigger, prescribed volume and subtype of RBC concentrates were adequate in 532 (65.3%), 460 (58.8%) and 805 (96.2%) of the transfusions, respectively. When the clinical picture was considered, prescription adequacy was higher compared to the use of the hemoglobin level alone (70.9% vs. 41%). The pICU had the highest correct trigger percentage (343 [71.6%]; p<0.001) while the ER showed more often adequate prescribed volumes (119 [66.1%]; p=0.020). The most common inadequacy regarding volume was that of prescriptions above the recommendation > 15 mL/kg found in 309 cases (36.9%). Thirty-two (32) RBC subtypes were requested and none were consistent with current recommendations. Conclusion:The results obtained in our study showed that RBC transfusion occurred more appropriately when the clinical picture was taken into account at request. There was a tendency to prescribe higher volumes and RBC subtypes without the justification of current protocols. Hemotherapic teachings at undergraduate level and medical residency must be improved.

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Section: Introductionmentioning

confidence: 99%

Assessment of the prescription of red blood cell concentrates in the pediatric age group

Faria

Victorino²,

Souza

et al. 2018

Rev. Assoc. Med. Bras.

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show abstract

“…Restrictive transfusion strategies were associated with a reduction in hospital mortality but not in 30-day mortality [16]. A review published in 2014 using restrictive hemoglobin transfusion triggers of 7 g/dl showed reductions in in-hospital mortality, total mortality, rebleeding, ACS, pulmonary edema, and bacterial infections compared with liberal transfusion [17].…”

Section: Evidence From Transfusion Trialsmentioning

confidence: 99%

Anemia and Blood Transfusion in the Critically Ill Patient with Cardiovascular Disease

Docherty¹,

Walsh²

2017

Annual Update in Intensive Care and Emergency Medicine

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“…No difference in infection risk was found in the disparate populations. 23 The motives for combining medical patients, gastrointestinal bleeding patients, and adults and children in the meta-analysis are not clear.…”

Section: Various Disease Groupsmentioning

confidence: 99%

Comparison of liberal and restrictive blood transfusion: current insights into clinical outcomes

Gregersen¹,

Damsgaard²

2016

IJCTM

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Impact of More Restrictive Blood Transfusion Strategies on Clinical Outcomes: A Meta-analysis and Systematic Review

Cited by 225 publications

References 62 publications

Assessment of the prescription of red blood cell concentrates in the pediatric age group

Assessment of the prescription of red blood cell concentrates in the pediatric age group

Anemia and Blood Transfusion in the Critically Ill Patient with Cardiovascular Disease

Comparison of liberal and restrictive blood transfusion: current insights into clinical outcomes

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