Do not perform blood transfusions for arbitrary Hb values > 70 g/l but evaluate the clinical need of each individual patient (bleeding, hemodynamic stability, comorbidity).
Type of practice
Other treatments
Routine transfusion of packed red blood cells in critically ill patients admitted to the Intensive Care Unit based on arbitrary hemoglobin values greater than 70 g/l is not recommended. Several studies have shown that using a low transfusion threshold (70 g/l instead of 90 g/l) is associated with equal or increased survival and reduces both costs and adverse events related to blood transfusions. Some categories of patients (elderly patients or patients with acute coronary syndrome) may, however, benefit from a more liberal transfusion threshold, although the evidence is not conclusive. In all cases, it is recommended to evaluate the clinical need of the individual patient (current or recent bleeding, hemodynamic stability/instability) rather than arbitrary hemoglobin values to decide whether to proceed with blood transfusion.
Sources
1. Vlaar AP, Oczkowski S, de Bruin S, et al. Transfusion strategies in non-bleeding critically ill adults: a clinical practice guideline from the European Society of Intensive Care Medicine. Intensive Care Med 2020;46:673-96.
2. Simon GI, Craswell A, Thom O, et al. (2017) Outcomes of restrictive versus liberal transfusion strategies in older adults from nine randomised controlled trials: a systematic review and meta-analysis. Lancet Haematol 2017; 4:e465–74.
3. Vincent JL, Baron JF, Reinhart K, et al. Anaemia and blood transfusion in critically ill patients. JAMA 2002; 288:1499-507.
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PDFAttention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.
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