Blood Transfusion Thresholds in Specific Populations
Sepsis - 7 g/dL
non-inferior to 9 g/dL (which was previously recommended in early goal-directed therapy and early Surviving Sepsis guidelines)
Acute Coronary Syndrome - no current specific recommendations pending further studies
recent MINT pilot study showed unexpected trend toward higher combined mortality and major cardiac events in restrictive transfusion arm (8 g/dL) vs. liberal arm (10 g/dL)
Stable Cardiovascular Disease - 8 g/dL
no difference in 30-day mortality compared to 10 g/dL, excluding those who have undergone cardiac surgery
no significant difference in neurologic recovery at 6 weeks or mortality vs. 10 g/dL, although there were more brain tissue hypoxia events in restrictive arm
anemia and transfusions both associated with worse outcomes in TBI
Postpartum Hemorrhage - 1:1:1 ratio strategy
FFP/RBC ratio ≥ 1 associated with improved patient outcomes
References
Cable CA, Razavi SA, Roback JD, Murphy DJ. RBC Transfusion Strategies in the ICU: A Concise Review. Crit Care Med. 2019; epub ahead of print.
