Liberal Versus Restrictive Hemoglobin Levels as Thresholds for Blood Transfusions

Blood transfusion is a common treatment of anemia due to chronic disease or acute blood loss.1 However, there continues to be uncertainty concerning theappropriate threshold for transfusion. A restrictive protocol could decrease blood administered, transmissible infections, transfusion reactions, vo...

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Bibliographic Details
Published in:Academic emergency medicine 2021-05, Vol.28 (5), p.593-594
Main Authors: Hillenkamp, John Z., Wolfson, Allan B., Zehtabchi, Shahriar
Format: Article
Language:English
Subjects:
Biomarkers
Blood transfusions
Emergency medical care
Evidence-based medicine
Hemoglobin
Systematic review
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Summary:Blood transfusion is a common treatment of anemia due to chronic disease or acute blood loss.1 However, there continues to be uncertainty concerning theappropriate threshold for transfusion. A restrictive protocol could decrease blood administered, transmissible infections, transfusion reactions, volume overload, and utilization of a limited commodity. However, anemia may result in decreased oxygen delivery, which could lead to metabolic dysfunction and increased cell death.2 Determining an appropriate transfusion threshold is thus an important objective. A previous Cochrane review3 found that the use of restrictive thresholds decreased transfusions compared to liberal thresholds. No difference in secondary outcomes, including 30-day mortality, hospital length of stay, cardiac events, and myocardial infarction, was noted. Here we summarize an updated Cochrane review of 31 trials and 12,587 adult participants.4
ISSN:1069-6563
1553-2712
DOI:10.1111/acem.14153