Transfusion strategies in non-bleeding critically ill adults: a clinical practice guideline from the European Society of Intensive Care Medicine

Strauss R et al (2002) Thrombocytopenia in patients in the medical intensive care unit: bleeding prevalence, transfusion requirements, and outcome. Crit Care Med 30:1765–1771 10.1097/00003246-200208000-00015

[3]

Walsh TS et al (2010) Prevalence, management, and outcomes of critically ill patients with prothrombin time prolongation in United Kingdom intensive care units. Crit Care Med 38:1939–1946 10.1097/ccm.0b013e3181eb9d2b

[4]

Khamiees M, Raju P, DeGirolamo A, Amoateng-Adjepong Y, Manthous CA (2001) Predictors of extubation outcome in patients who have successfully completed a spontaneous breathing trial. Chest 120:1262–1270 10.1378/chest.120.4.1262

[5]

Vanderschueren S et al (2000) Thrombocytopenia and prognosis in intensive care. Crit Care Med 28:1871–1876 10.1097/00003246-200006000-00031

[6]

Rasmussen L, Christensen S, Lenler-Petersen P, Johnsen SP (2010) Anaemia and 90-day mortality in COPD patients requiring invasive mechanical ventilation. Clin Epidemiol 3:1–5

[7]

Bolton-Maggs PHB (2016) SHOT conference report 2016: serious hazards of transfusion—human factors continue to cause most transfusion-related incidents. Transfus Med 26:401–405 10.1111/tme.12380

[8]

Goldman M et al (2005) Proceedings of a consensus conference: towards an understanding of TRALI. Transfus Med Rev 19:2–31 10.1016/j.tmrv.2004.10.001

[9]

A Multicenter, Randomized, Controlled Clinical Trial of Transfusion Requirements in Critical Care

Paul C. Hébert, George Wells, Morris A. Blajchman et al.

New England Journal of Medicine 1999 10.1056/nejm199902113400601

[10]

Curley A et al (2018) Randomized trial of platelet-transfusion thresholds in neonates. N Engl J Med. https://doi.org/10.1056/nejmoa1807320 10.1056/nejmoa1807320

[11]

Outcomes of restrictive versus liberal transfusion strategies in older adults from nine randomised controlled trials: a systematic review and meta-analysis

Geoff I Simon, Alison Craswell, Ogilvie Thom et al.

The Lancet Haematology 2017 10.1016/s2352-3026(17)30141-2

[12]

Carson JL, Stanworth SJ, Roubinian N, Fergusson DA, Triulzi D, Doree C, Hebert PC (2016) Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion. Cochrane Database of Syst Rev 10:CD002042

[13]

Vincent JL et al (2002) Anaemia and blood transfusion in critically ill patients. J Am Med Assoc 288:1499–1507 10.1001/jama.288.12.1499

[14]

Schofield WN, Rubin GL, Dean MG (2003) Appropriateness of platelet, fresh frozen plasma and cryoprecipitate transfusion in New South Wales public hospitals. Med J Aust 178:117–121 10.5694/j.1326-5377.2003.tb05101.x

[15]

Stanworth SJ et al (2011) A national study of plasma use in critical care: clinical indications, dose and effect on prothrombin time. Crit Care 15:R108 10.1186/cc10129

[16]

Yang L, Stanworth S, Hopewell S, Doree C, Murphy M (2012) Is fresh-frozen plasma clinically effective? An update of a systematic review of randomized controlled trials. Transfusion 52:1673–1686 10.1111/j.1537-2995.2011.03515.x

[17]

Napolitano LM, Kurek S, Luchette FA, Corwin HL, Barie PS, Tisherman SA, Hebert PC, Anderson GL, Bard MR, Bromberg W, Chiu WC (2009) Clinical practice guideline: red blood cell transfusion in adult trauma and critical care. Crit Care Med 37(12):3124–3157 10.1097/ccm.0b013e3181b39f1b

[18]

Carson JL, Guyatt G, Heddle NM, Grossman BJ, Cohn CS, Fung MK, Gernsheimer T, Holcomb JB, Kaplan LJ, Katz LM, Peterson N (2016) Clinical practice guidelines from the AABB: red blood cell transfusion thresholds and storage. JAMA 316(19):2025–2035 10.1001/jama.2016.9185

[19]

Mueller MM, Van Remoortel H, Meybohm P, Aranko K, Aubron C, Burger R, CarsonJL Cichutek K, De Buck E, Devine D, Fergusson D, Folléa G, French C, Frey KP, Gammon R, Levy JH, Murphy MF, Ozier Y, Pavenski K, So-Osman C, Tiberghien P, Volmink J, Waters JH, Wood EM, Seifried E, ICC PBM Frankfurt 2018 Group (2019) Patient blood management: recommendations from the 2018 Frankfurt Consensus Conference. JAMA 321(10):983–997 10.1001/jama.2019.0554

[20]

Padhi S, Kemmis-Betty S, Rajesh S, Hill J, Murphy MF (2015) Guideline development. Blood transfusion: summary of NICE guidance. BMJ 351:h5832 10.1136/bmj.h5832

[21]

Klein AA, Arnold P, Bingham RM, Brohi K, Clark R, Collis R et al (2016) AAGBI guidelines: the use of blood components and their alternatives. Anaesthesia 2016(71):829–842 10.1111/anae.13489

[22]

Vlaar AP, Juffermans NP (2013) Transfusion-related acute lung injury: a clinical review. Lancet 382(9896):984–994 10.1016/s0140-6736(12)62197-7

[23]

Valentine SL, Bembea MM, Muszynski JA et al (2018) Consensus recommendations for RBC transfusion practice in critically Ill children from the pediatric critical care transfusion and anemia expertise initiative. Pediatr Crit Care Med 19:884–898 10.1097/pcc.0000000000001613

[24]

GRADE: an emerging consensus on rating quality of evidence and strength of recommendations

Gordon H Guyatt, Andrew D Oxman, Gunn E Vist et al.

BMJ 2008 10.1136/bmj.39489.470347.ad

[25]

De Bruin S, Vlaar AP, Scheeren TW et al (2019) Transfusion practice on the intensive care unit; an international online survey—the TRACE Survey. Crit Care 23:309 10.1186/s13054-019-2591-6

[26]

Guyatt GH, Oxman AD, Kunz R, Atkins D, Brozek J, Vist G, Alderson P, Glasziou P, Falck-Ytter Y, Schünemann HJ (2011) GRADE guidelines: 2. Framing the question and deciding on important outcomes. J Clin Epidermiol 64(4):395–400 10.1016/j.jclinepi.2010.09.012

[27]

Rayyan—a web and mobile app for systematic reviews

Mourad Ouzzani, Hossam Hammady, Zbys Fedorowicz et al.

Systematic Reviews 2016 10.1186/s13643-016-0384-4

[28]

The Cochrane Collaboration's tool for assessing risk of bias in randomised trials

J. P. T. Higgins, D. G. Altman, P. C. Gotzsche et al.

BMJ 2011 10.1136/bmj.d5928

[29]

Peterson J, Welch V, Losos M, Tugwell P (2011) The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa Hospital Research Institute, Ottawa. https://ca/programs/clinical_epidemiology/oxford.asp.2001

[30]

Cornell JE, Mulrow CD, Localio R, Stack CB, Meibohm AR, Guallar E, Goodman SN (2014) Random-effects meta-analysis of inconsistent effects: a time for change. Ann Intern Med 160(4):267–270 10.7326/m13-2886

[31]

Guyatt GH, Oxman AD, Vist G, Kunz R, Brozek J, Alonso-Coello P, Montori V, Akl EA, Djulbegovic B, Falck-Ytter Y, Norris SL (2011) GRADE guidelines: 4. Rating the quality of evidence—study limitations (risk of bias). J Clin Epidemiol 64(4):407–415 10.1016/j.jclinepi.2010.07.017

[32]

Guyatt GH, Oxman AD, Kunz R, Woodcock J, Brozek J, Helfand M, Alonso-Coello P, Glasziou P, Jaeschke R, Akl EA, Norris S (2011) GRADE guidelines: 7. Rating the quality of evidence—inconsistency. J Clin Epidemiol 64(12):1294–1302 10.1016/j.jclinepi.2011.03.017

[33]

Guyatt GH, Oxman AD, Kunz R, Woodcock J, Brozek J, Helfand M, Alonso-Coello P, Falck-Ytter Y, Jaeschke R, Vist G, Akl EA (2011) GRADE guidelines: 8. Rating the quality of evidence—indirectness. J Clin Epidemiol 64(12):1303–1310 10.1016/j.jclinepi.2011.04.014

[34]

Guyatt GH, Oxman AD, Kunz R, Brozek J, Alonso-Coello P, Rind D, Devereaux PJ, Montori VM, Freyschuss B, Vist G, Jaeschke R (2011) GRADE guidelines 6. Rating the quality of evidence—imprecision. J Clin Epidemiol 64(12):1283–1293 10.1016/j.jclinepi.2011.01.012

[35]

Alonso-Coello P, Oxman AD, Moberg J et al (2016) GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 2: clinical practice guidelines. BMJ 353:i2089 10.1136/bmj.i2089

[36]

Andrews JC, Schunemann HJ, Oxman AD et al (2013) GRADE guidelines: 15. Going from evidence to recommendation—determinants of a recommendation’s direction and strength. J Clin Epidemiol 66:726–735 10.1016/j.jclinepi.2013.02.003

[37]

Guyatt GH, Oxman AD, Kunz R, Falck- Ytter Y, Vist GE, Liberati A et al (2008) Going from evidence to recommendations. BMJ 336(7652):1049–1051 10.1136/bmj.39493.646875.ae

[38]

Hébert PC, Wells G, Marshall J, Martin C, Tweeddale M, Pagliarello G, Blajchman M, Wood G, Hill R, Granton J, Calvin J (1995) Transfusion requirements in critical care: a pilot study. JAMA 273(18):1439–1444 10.1001/jama.1995.03520420055038

[39]

Walsh TS, Boyd JA, Watson D, Hope D, Lewis S, Krishan A, Forbes JF, Ramsay P, Pearse R, Wallis C, Cairns C (2013) Restrictive versus liberal transfusion strategies for older mechanically ventilated critically ill patients: a randomized pilot trial. Crit Care Med 41(10):2354–2363 10.1097/ccm.0b013e318291cce4

[40]

Holst LB, Haase N, Wetterslev J, Wernerman J, Guttormsen AB, Karlsson S, Johansson PI, Åneman A, Vang ML, Winding R, Nebrich L (2014) Lower versus higher haemoglobin threshold for transfusion in septic shock. N Engl J Med 371(15):1381–1391 10.1056/nejmoa1406617

[41]

Mazza BF, Freitas FG, Barros MM, Azevedo LC, Machado FR (2015) Blood transfusions in septic shock: is 7.0 g/dL really the appropriate threshold? Rev Bras Ter Intensiva 27(1):36–43 10.5935/0103-507x.20150007

[42]

Cooper HA, Rao SV, Greenberg MD, Rumsey MP, McKenzie M, Alcorn KW, Panza JA (2011) Conservative versus liberal red cell transfusion in acute myocardial infarction (the CRIT Randomized Pilot Study). Am J Cardiol 108(8):1108–1111 10.1016/j.amjcard.2011.06.014

[43]

Carson JL, Brooks MM, Abbott JD, Chaitman B, Kelsey SF, Triulzi DJ, Srinivas V, Menegus MA, Marroquin OC, Rao SV, Noveck H (2013) Liberal versus restrictive transfusion thresholds for patients with symptomatic coronary artery disease. Am Heart J 165(6):964–971 10.1016/j.ahj.2013.03.001

[44]

Lenz C, Rebel A, Waschke KF, Koehler RC, Frietsch T (2007) Blood viscosity modulates tissue perfusion—sometimes and somewhere. Transfus Altern Transfus Med 9(4):265–272 10.1111/j.1778-428x.2007.00080.x

[45]

Effect of restrictive versus liberal transfusion strategies on outcomes in patients with cardiovascular disease in a non-cardiac surgery setting: systematic review and meta-analysis

Annemarie B Docherty, Rob O’Donnell, Susan Brunskill et al.

BMJ 2016 10.1136/bmj.i1351

[46]

Bergamin FS, Almeida JP, Landoni G, Galas FR, Fukushima JT, Fominskiy E, Park CH, Osawa EA, Diz MP, Oliveira GQ, Franco RA (2017) Liberal versus restrictive transfusion strategy in critically ill oncologic patients: the transfusion requirements in critically ill oncologic patients randomized controlled trial. Crit Care Med 45(5):766–773 10.1097/ccm.0000000000002283

[47]

Hébert PC, Blajchman MA, Cook DJ, Yetisir E, Wells G, Marshall J, Schweitzer I (2001) Do blood transfusions improve outcomes related to mechanical ventilation? Chest 119(6):1850–1857 10.1378/chest.119.6.1850

[48]

Johnson RG, Thurer RL, Kruskall MS, Sirois C, Gervino EV, Critchlow J, Weintraub RM (1992) Comparison of two transfusion strategies after elective operations for myocardial revascularization. J Thorac Cardiovasc Surg 104(2):307–314 10.1016/s0022-5223(19)34782-8

[49]

Bracey AW, Radovancevic R, Riggs SA, Houston S, Cozart H, Vaughn WK, Radovancevic B, McAllister HA Jr, Cooley DA (1999) Lowering the haemoglobin threshold for transfusion in coronary artery bypass procedures: effect on patient outcome. Transfusion 39(10):1070–1077 10.1046/j.1537-2995.1999.39101070.x

[50]

Hajjar LA, Vincent JL, Galas FR, Nakamura RE, Silva CM, Santos MH, Fukushima J, Kalil Filho R, Sierra DB, Lopes NH, Mauad T (2010) Transfusion requirements after cardiac surgery: the TRACS randomized controlled trial. JAMA 304(14):1559–1567 10.1001/jama.2010.1446

Showing 50 of 150 references

Cited By

194

Beyond hemoglobin thresholds: A physiology-guided framework for red blood cell transfusion in non-bleeding critically ill patients

Thanh Luan Nguyen, Quang Dai Le · 2026

Science Progress

Anemia of Critical Illness: A Concise Definitive Review in Critical Care

Howard L. Corwin, Lena M. Napolitano · 2025

Critical Care Medicine

Oxygen extraction–guided transfusion strategy in critically ill patients: study protocol for a randomised, open-labelled, controlled trial

Alberto Fogagnolo, Danila Azzolina · 2024

BMJ Open

Management of Potential Organ Donor: Indian Society of Critical Care Medicine—Position Statement

RK Mani, Sunil Karanth · 2024

Indian Journal of Critical Care Med...

Red Blood Cell Transfusion in the Intensive Care Unit

Senta Jorinde Raasveld, Sanne de Bruin · 2023

JAMA

Platelet Transfusion before CVC Placement in Patients with Thrombocytopenia

Floor L.F. van Baarle, Emma K. van de Weerdt · 2023

New England Journal of Medicine

Anesthetic management of patients with sepsis/septic shock

Andrea Carsetti, Eva Vitali · 2023

Frontiers in Medicine

Metrics

194

Citations

150

References

Details

Published: Jan 07, 2020
Vol/Issue: 46(4)
Pages: 673-696
License: View

Authors

Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

Dipartimento di Scienze dell’ Emergenza Anestesiologiche e della Rianimazione, Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

for the Stop-or-Not Trial Group

Rigshospitalet, Copenhagen, Denmark.

From the Department of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine (A.F.T., M.V., M.S.-O., F. Lauzier), the Department of Social and Preventive Medicine (L.M.), the Department of Surgery, Division of Neurosurgery (P.L.B.), the Department of Medicine (V.L., F. Lauzier), and the Department of Family and Emergency Medicine (M.S.-O.), Faculty of Medicine, Université Laval, the Population Health and Optimal Health Practice Unit, Centre Hospitalier Universitaire de Québec-Université Laval Research Center (A.F.T., L.C., M.-P.P., X.N., L.M., P.L.B., M.V., M.S.-O., O.C., F. Lauzier), and the Department of Anesthesia, Critical Care Medicine Service, Hôpital de L’Enfant-Jésus, Centre Hospitalier Universitaire de Québec-Université Laval (A.F.T., F. Lauzier), Quebec City, QC, Ottawa Hospital Research Institute (D.A.F., S.W.E., T.R., M.T., A.T.), the School of Epidemiology and Public Health (D.A.F., S.W.E., T.R., M.T., A.T.), the Division of Critical Care (S.W.E.), the Division of Hemat...

G

Gordon Guyatt

Department of Health Research Methods, Evidence and Impact McMaster University Hamilton ON Canada

Department of Anesthesia and Intensive Care, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.

Funding

European Society of Intensive Care Medicine

Cite This Article

Alexander P. Vlaar, Simon Oczkowski, Sanne de Bruin, et al. (2020). Transfusion strategies in non-bleeding critically ill adults: a clinical practice guideline from the European Society of Intensive Care Medicine. Intensive Care Medicine, 46(4), 673-696. https://doi.org/10.1007/s00134-019-05884-8

Transfusion strategies in non-bleeding critically ill adults: a clinical practice guideline from the European Society of Intensive Care Medicine

You May Also Like