ReviewTransfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie2015
Evidence base for restrictive transfusion triggers in high-risk patients.
Review in Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 43 citations in OpenAlex.
- Implementation of new standard operating procedures for geriatric trauma patients with multiple injuries: a single level I trauma centre study.BMC geriatrics · 2019Trial
- Consequences of anemia in geriatric hip fractures: how low is too low?Trauma surgery & acute care open · 2024Article
- A retrospective cohort study of 27,049 polytraumatized patients age 60 and above: identifying changes over 16 years.European geriatric medicine · 2022Article
- [Perioperative cardiovasular morbidity and mortality in noncardiac surgical interventions : Measures for optimal anesthesiological care].Der Anaesthesist · 2019Review
- Sepsis: The evolution in definition, pathophysiology, and management.SAGE open medicine · 2019Review
- Comparison of two different coagulation algorithms on the use of allogenic blood products and coagulation factors in severely injured trauma patients: a retrospective, multicentre, observational study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2018Observational
- [Thrombocytopenia in the intensive care unit].Wiener klinisches Magazin : Beilage zur Wiener klinischen Wochenschrift · 2017Article
- National and International Guidelines for Patient Blood Management in Obstetrics: A Qualitative Review.Anesthesia and analgesia · 2017Review
- [Thrombocytopenia in the intensive care unit : Diagnosis, differential diagnosis, and treatment].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2016Review
- Reducing transfusion requirements in liver transplantation.World journal of transplantation · 2015Review
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
unlabelledLiberal versus restrictive red blood cell (RBC) transfusion triggers have been debated for years. This review illustrates the human body's physiologic response to acute anemia and summarizes the evidence from prospective randomized trials (RCTs) for restrictive use of RBC transfusions in high-risk patients. During progressive anemia, the human body maintains the oxygen delivery to the tissues by an increase in cardiac output and peripheral oxygen extraction. Seven RCTs with a total of 5,566 high-risk patients compared a restrictive hemoglobin (Hb) transfusion trigger (Hb < 70 or < 80 g/l) with a liberal Hb transfusion trigger (Hb < 90 or < 100 g/l). Unanimously these studies show non-inferiority, safety, and a significant reduction in RBC transfusions in the restrictive groups. In one RCT mortality was higher in the liberal Hb transfusion group, and in two additional RCTs mortality of subgroups or after risk adjustment was significantly higher in the liberal Hb transfusion trigger groups.
conclusionStrong RCT evidence suggests the safety of restrictive transfusion triggers. As a consequence, an Hb transfusion trigger of <70 g/l is recommended for high risk patients.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.