What’s new in transfusion policies?

A liberal strategy of red blood cell transfusion reduces cardiogenic shock in elderly patients undergoing cardiac surgery

“…Despite these limitations, a restrictive transfusion strategy resulted in an increased rate of cardiogenic shock in elderly patients undergoing cardiac surgery compared with a more liberal strategy, suggesting that in this specific population, the cardiovascular risk of anemia may be more harmful than the risk of blood transfusion. 25,26…”

Past, present, and future: a qualitative and literature study identifying historical trends, drivers, and transformational factors for the future demand of blood supply in the Netherlands

“…Further, Dutch experts (3/42; 7%, all with up to 20 years of experience) shared that another reason is the increasing migrant population (including first‐ and second‐generation migrants) with diseases of hemoglobinopathy and/or thalassemia. Studies on sickle cell patients record this increased demand due to increasing indications, while others state that optimal treatment for this patient group may be to increase transfusion usage . Furthermore, in the Netherlands, due to the TAPS (Transfusion Alternatives Preoperatively in Sickle Cell Disease) study, all Dutch patients with sickle cell disease having surgery under general anesthesia now are administered a preoperative transfusion, warranting more transfusion.…”

“…The combination of this evidence, challenged medical perspectives and brought awareness of transfusion's adverse reactions, which was "an eye-opener" (Dutch Expert 6) due to the traditional only-beneficial perspective experts had. Four articles [27][28][29][30] reflect on particular studies that have shaped the evolution of transfusion. One author questions whether transfusion has now become too restrictive 29 and warns that the evidence is still limited with gaps in knowledge.…”

Year in review in Intensive Care Medicine 2013: II. Sedation, invasive and noninvasive ventilation, airways, ARDS, ECMO, family satisfaction, end-of-life care, organ donation, informed consent, safety, hematological issues in critically ill patients

“…In their ''What's New in Intensive Care Medicine'' on transfusion, Hajjar and Vincent [83] reviewed the recently published studies reporting results that raise concerns on the use restrictive transfusion strategy in some subgroups of patients requiring intensive care. This issue becomes even more critical as blood collection, processing, and storage have improved, which may prevent and minimize many of the known adverse effects of blood transfusion.…”