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Evidence
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1. NICE Guideline Recommendations:
13. Use restrictive red blood cell transfusion thresholds for patients who need red blood cell transfusions and who do not:
• have major haemorrhage or
• have acute coronary syndrome or
• need regular blood transfusions for chronic anaemia.
14. When using a restrictive red blood cell transfusion threshold, consider a threshold of 70 g/litre and a haemoglobin concentration target of 70–90 g/litre after transfusion.
16. Consider setting individual thresholds and haemoglobin concentration targets for each patient who needs regular blood transfusions for chronic anaemia.
Other refs:
1. Odutayo A, Desborough MJ, Trivella M, Stanley AJ, Doree C, Collins GS, et al. Restrictive versus liberal blood transfusion for gastrointestinal bleeding: a systematic review and meta-analysis of randomised controlled trials. The Lancet Gastroenterology & Hepatology. 2017;2(-5):354-60.
2. Estcourt LJ, Malouf R, Trivella M, Fergusson DA, Hopewell S, Murphy MF. Restrictive versus liberal red blood cell transfusion strategies for people with haematological malignancies treated with intensive chemotherapy or radiotherapy, or both, with or without haematopoietic stem cell support. The Cochrane Database of Systematic Reviews. 2017(-1):CD011305-CD.
3. Dupuis C, Sonneville R, Adrie C, Gros A, Darmon M, Bouadma L, et al. Impact of transfusion on patients with sepsis admitted in intensive care unit: a systematic review and meta-analysis. Annals of Intensive Care. 2017;7(-1):5-.
4. Veigas PV, Callum J, Rizoli S, Nascimento B, da Luz LT. A systematic review on the rotational thrombelastometry (ROTEM(R)) values for the diagnosis of coagulopathy, prediction and guidance of blood transfusion and prediction of mortality in trauma patients. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2016;24(-1):114-.
5. Prescott LS, Taylor JS, Lopez-Olivo MAMMF, VonVille HM, Lairson DR, Bodurka DC. How low should we go: a systematic review and meta-analysis of the impact of restrictive red blood cell transfusion strategies in oncology. Cancer Treatment Reviews. 2016;46:1-8.
6. Keir A, Pal S, Trivella M, Lieberman L, Callum J, Shehata N, et al. Adverse effects of red blood cell transfusions in neonates: a systematic review and meta-analysis. Transfusion. 2016.
7. Estcourt LJ, Ingram C, Doree C, Trivella M, Stanworth SJ. Use of platelet transfusions prior to lumbar punctures or epidural anaesthesia for the prevention of complications in people with thrombocytopenia. The Cochrane Database of Systematic Reviews. 2016(-5):CD011980-CD.
8. Christou G, Iyengar A, Shorr R, Tinmouth A, Saidenberg E, Maze D, et al. Optimal transfusion practices after allogeneic hematopoietic cell transplantation: a systematic scoping review of evidence from randomized controlled trials. Transfusion. 2016.
9. Boutin A, Chasse M, Shemilt M, Lauzier F, Moore L, Zarychanski R, et al. Red blood cell transfusion in patients with traumatic brain injury: a systematic review and meta-analysis. Transfusion Medicine Reviews. 2016;30(-1):15-24.
10. McQuilten ZK, Crighton G, Brunskill S, Morrison JK, Richter T, Waters N, Murphy MF, Wood EM. Optimal Dose, Timing and Ratio of Blood Products in Massive Transfusion: Results from a Systematic Review. Transfusion Medicine Reviews. 2017.
11. Gu Y, Estcourt LJ, Doree C, Hopewell S, Vyas P. Comparison of a restrictive versus liberal red cell transfusion policy for patients with myelodysplasia, aplastic anaemia, and other congenital bone marrow failure disorders. Cochrane Database of Systematic Reviews. 2015(-10):CD011577-CD.
12. Estcourt LJ, Stanworth SJ, Doree C, Hopewell S, Trivella M, Murphy MF. Comparison of different platelet count thresholds to guide administration of prophylactic platelet transfusion for preventing bleeding in people with haematological disorders after myelosuppressive chemotherapy or stem cell transplantation. Cochrane Database of Systematic Reviews. 2015(-11):CD010983-CD.
13. Estcourt LJ, Stanworth S, Doree C, Trivella M, Hopewell S, Blanco P, et al. Different doses of prophylactic platelet transfusion for preventing bleeding in people with haematological disorders after myelosuppressive chemotherapy or stem cell transplantation. Cochrane Database of Systematic Reviews. 2015(-10):CD010984-CD.
14. Estcourt LJ, Desborough M, Hopewell S, Doree C, Stanworth SJ. Comparison of different platelet transfusion thresholds prior to insertion of central lines in patients with thrombocytopenia. Cochrane Database of Systematic Reviews. 2015(-12):CD011771-CD.
15. English SW, Chasse M, Turgeon AF, Tinmouth A, Boutin A, Pagliarello G, et al. Red blood cell transfusion and mortality effect in aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis protocol. Systems Review. 2015;4(-1):41-.
16. Crighton GL, Estcourt LJ, Wood EM, Trivella M, Doree C, Stanworth S. A therapeutic-only versus prophylactic platelet transfusion strategy for preventing bleeding in patients with haematological disorders after myelosuppressive chemotherapy or stem cell transplantation. Cochrane Database of Systematic Reviews. 2015(-9):CD010981-CD.
17. Chan AW, de Gara CJ. An evidence-based approach to red blood cell transfusions in asymptomatically anaemic patients. Annals of the Royal College of Surgeons of England. 2015;97(-8):556-62.
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