2015
DOI: 10.1007/s00134-015-3950-7
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Should red cell transfusion be individualized? Yes

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Cited by 20 publications
(14 citation statements)
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“…The guidelines are based on results from several randomized clinical studies that showed that liberal transfusion strategies (keeping Hb > 9-10 g/dL) provided no clinical benefit in different populations when compared to a restrictive strategy [11][12][13][14]. However, the decision to transfuse should not be based only on Hb concentration [15,16], because the optimal DO 2 can differ from one patient to another [17] and over time in any one patient. These elements have resulted in considerable variability in worldwide transfusion practice, with the average Hb concentrations used to initiate transfusions higher than those recommended [7].…”
Section: Introductionmentioning
confidence: 99%
“…The guidelines are based on results from several randomized clinical studies that showed that liberal transfusion strategies (keeping Hb > 9-10 g/dL) provided no clinical benefit in different populations when compared to a restrictive strategy [11][12][13][14]. However, the decision to transfuse should not be based only on Hb concentration [15,16], because the optimal DO 2 can differ from one patient to another [17] and over time in any one patient. These elements have resulted in considerable variability in worldwide transfusion practice, with the average Hb concentrations used to initiate transfusions higher than those recommended [7].…”
Section: Introductionmentioning
confidence: 99%
“…Our sensitivity analyses further indicate such variations have substantial impact on cost‐effectiveness, highlighting the need to reinforce implementation of protocols that outweigh benefits against cost and risk. Third, we are also informed that good clinical judgements may also contribute to personalized transfusion , as reflected by the result that patients not transfused were generally at very low risk of adverse outcomes, even at Hb <8 g/dl. This renders routine practice, though with fewer RBCs transfused, related to better patient outcomes when restrictive protocol was even slightly violated.…”
Section: Discussionmentioning
confidence: 99%
“…Tailored treatment and lack of standards are the double edges of routine transfusion. Towards an era of precise patient blood management , an iterative circle of ‘summarize experience ‐ validate protocol ‐ refine practice’ needs to be established.…”
Section: Discussionmentioning
confidence: 99%
“…distinguished two different settings: (1) in young and non‐severe patients, without coexisting substantial comorbidities, it is safe to restrict the decision to transfuse to the Hb level; (2) in other clinical situations, Hb is the primary determinant for RBC transfusion, but all the above parameters must be integrated to individualise the transfusion decision‐making process . It has also been suggested that additional biological parameters may be useful in this setting to better guide clinicians in their decision making . Physiologic transfusion triggers may include indices of tissue perfusion, central oxygen venous saturation or jugular oxygen venous saturation in neuro critically ill patients .…”
Section: Is Haemoglobin the Only Transfusion Trigger To Consider?mentioning
confidence: 99%
“…It has also been suggested that additional biological parameters may be useful in this setting to better guide clinicians in their decision making . Physiologic transfusion triggers may include indices of tissue perfusion, central oxygen venous saturation or jugular oxygen venous saturation in neuro critically ill patients . Further research is warranted to define the benefit of the use of additional transfusion triggers.…”
Section: Is Haemoglobin the Only Transfusion Trigger To Consider?mentioning
confidence: 99%