1. Transfusion thresholds for guiding red blood cell transfusion.
- Author
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Carson, Jeffrey L, Carson, Jeffrey L, Stanworth, Simon J, Dennis, Jane A, Trivella, Marialena, Roubinian, Nareg, Fergusson, Dean A, Triulzi, Darrell, Dorée, Carolyn, Hébert, Paul C, Carson, Jeffrey L, Carson, Jeffrey L, Stanworth, Simon J, Dennis, Jane A, Trivella, Marialena, Roubinian, Nareg, Fergusson, Dean A, Triulzi, Darrell, Dorée, Carolyn, and Hébert, Paul C
- Abstract
BackgroundThe optimal haemoglobin threshold for use of red blood cell (RBC) transfusions in anaemic patients remains an active field of research. Blood is a scarce resource, and in some countries, transfusions are less safe than in others because of inadequate testing for viral pathogens. If a liberal transfusion policy does not improve clinical outcomes, or if it is equivalent, then adopting a more restrictive approach could be recognised as the standard of care. OBJECTIVES: The aim of this review update was to compare 30-day mortality and other clinical outcomes for participants randomised to restrictive versus liberal red blood cell (RBC) transfusion thresholds (triggers) for all clinical conditions. The restrictive transfusion threshold uses a lower haemoglobin concentration as a threshold for transfusion (most commonly, 7.0 g/dL to 8.0 g/dL), and the liberal transfusion threshold uses a higher haemoglobin concentration as a threshold for transfusion (most commonly, 9.0 g/dL to 10.0 g/dL).Search methodsWe identified trials through updated searches: CENTRAL (2020, Issue 11), MEDLINE (1946 to November 2020), Embase (1974 to November 2020), Transfusion Evidence Library (1950 to November 2020), Web of Science Conference Proceedings Citation Index (1990 to November 2020), and trial registries (November 2020). We checked the reference lists of other published reviews and relevant papers to identify additional trials. We were aware of one trial identified in earlier searching that was in the process of being published (in February 2021), and we were able to include it before this review was finalised.Selection criteriaWe included randomised trials of surgical or medical participants that recruited adults or children, or both. We excluded studies that focused on neonates. Eligible trials assigned intervention groups on the basis of different transfusion schedules or thresholds or 'triggers'. These thresholds would be define
- Published
- 2021