Evidence map›Paper›PMID 39341492›Full record

GuidelineChest2025

Red Blood Cell Transfusion in Critically Ill Adults: An American College of Chest Physicians Clinical Practice Guideline.

Angel O Coz Yataco, Israa Soghier, Paul C Hébert, Emilie Belley-Cote, Margaret Disselkamp, David Flynn, Karin Halvorson, Jonathan M Iaccarino, Wendy Lim, Christina C Lindenmeyer and 5 more

Abstract readPractice GuidelineReview
PubMed Full text at PMC Publisher
In one paragraph

Guideline in Chest, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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  5. [Interpretation of the 2025Zhonghua shao shang yu chuang mian xiu fu za zhi · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Angel O Coz YatacoCritical Care Medicine Division and Pulmonary Medicine Division, Integrated Hospital-Care Institute, Cleveland, OH; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH. Electronic address: cozyata@ccf.org.
Israa SoghierDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Salem Hospital/Massachusetts General Brigham, Salem, MA; American College of Chest Physicians, Glenview, IL.
Paul C HébertBruyere Research Institute, University of Ottawa, Ottawa, ON, Canada.
Emilie Belley-CotePopulation Health Research Institute, Hamilton, ON, Canada.
Margaret DisselkampDepartment of Critical Care and Pulmonary Medicine, Lexington Veterans Affairs Healthcare System, Lexington, KY.
David FlynnBoston University Chobanian & Avedisian School of Medicine, Boston, MA.
Karin HalvorsonDepartment of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI.
Jonathan M IaccarinoAmerican College of Chest Physicians, Glenview, IL.
Wendy LimDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Christina C LindenmeyerDepartment of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic, Cleveland, OH.
Peter J MillerSection of Pulmonary, Critical Care, Allergy and Immunologic Disease, Section on Hematology and Oncology, Department of Medicine, Section on Critical Care Medicine, Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC.
Kevin O'NeilWilmington Health and MICU, Novant New Hanover Regional Medical Center, Wilmington, NC.
Kathryn M PendletonDivision of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN.
Lisa Vande VusseDivision of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington, Seattle, WA.
Daniel R OuelletteDivision of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, MI.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBlood products frequently are administered to critically ill patients. Considering recent trials and practice variability, a comprehensive review of current evidence was deemed essential to offer pertinent guidance to critical care practitioners. This American College of Chest Physicians (CHEST) guidelines panel examined the literature on RBC transfusions among critically ill patients overall and specific subgroups, including patients with gastrointestinal bleeding, acute coronary syndrome (ACS), cardiac surgery, isolated troponin elevation, and septic shock, to provide evidence-based recommendations. STUDY DESIGN AND

methodsA panel of experts developed six Population, Intervention, Comparator, and Outcome questions addressing RBC transfusions in critically ill patients and performed a comprehensive evidence review. The panel applied the Grading of Recommendations, Assessment, Development, and Evaluations approach to assess the certainty of evidence and to formulate and grade recommendations. A modified Delphi technique was used to reach consensus on the recommendations.

resultsThe initial search identified a total of 3,082 studies, and after the initial screening, 38 articles were reviewed. Among them, 23 studies met inclusion criteria, comprising 22 randomized controlled trials and one cohort study. Based on the analysis of these studies, the panel formulated two strong and four conditional recommendations. The overall quality of evidence for recommendations ranged from very low to moderate.

conclusionsIn most critically ill patients, a restrictive strategy was preferable to a permissive approach because it does not increase the risk of death or complications, but does decrease RBC use significantly. Data from critically ill subpopulations also supported a restrictive approach, except in patients with ACS, for whom favoring a restrictive approach could increase adverse outcomes.

Indexed as

Critical CareCritical IllnessErythrocyte TransfusionAcute Coronary SyndromeAdultHumansSocieties, MedicalUnited Statesacute coronary syndromecardiac surgerycritically illGI bleedred blood cellsepsisseptic shocktransfusion

Identifiers

PMID39341492
PMCPMC11867898

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.