Restrictive transfusion strategy of red cell concentrate often optimal for most patients, asserts AABB Guideline
Blood
USA: The panel of international experts, led by a working group initiated by the Association for the Advancement of Blood & Biotherapies (AABB), have released a new international guideline on red blood cell (RBC) transfusion.
In their guideline published in the Journal of the American Medical Association (JAMA), the panel recommend that a restrictive transfusion strategy is often optimal for most patients requiring RBC transfusions. However, the panel urged that an overall clinical context, including symptoms, signs, patient values and preferences, and co-morbidities conditions, that will differ between patients should be taken into account on a case-by-case basis to ensure each patient receives optimal treatment.
"It is good practice to consider the overall clinical context and alternative therapies for transfusion when making transfusion decisions about an individual patient," the guideline stated.
The panel of experts used a meta-analysis and systematic review from Cochrane to determine optimal transfusion strategies. For adult populations, Jeffrey L. Carson, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, and the team reviewed seven randomized clinical trials comprising 2,730 patients. The panel compared patient outcomes with restrictive hemoglobin-based transfusion thresholds – defined as 7 to 8 g/dL – with more liberal transfusion thresholds – defined as 9 to 10 g/dL.
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