Meta-Analysis

Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion

Carson JL, Stanworth SJ, Roubinian N, et al., 2021 · 37 studies included

Summary

Cochrane systematic review of 37 randomized trials (n=19,049) comparing restrictive (Hb 7.0-8.0 g/dL) vs liberal (Hb 9.0-10.0 g/dL) RBC transfusion strategies.

Conclusion

Restrictive transfusion strategies reduced the proportion of patients transfused by 41% with no increase in 30-day mortality, cardiac events, stroke, or infection across critical care, surgery, and trauma.

High certainty

Clinical Context & Relevant Topics (2)

Disease Reference

Blood Product Transfusion in Critical Care

Patient-specific RBC transfusion thresholds, current platelet/procedural thresholds, plasma/cryoprecipitate use, and the TRALI vs TACO diagnostic matrix.

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Major Bleeding, Hemorrhagic Shock, & Damage Control Resuscitation

The trauma lethal diamond (hypothermia, acidosis, coagulopathy, hypocalcemia), 1:1:1 massive transfusion (PROPPR trial), early TXA (CRASH-2), and TEG/ROTEM algorithms.

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