Transfusion Requirements in Anesthesia and Intensive Care
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Purpose of Review
Allogeneic blood products are commonly used in perioperative and critically ill patients. This review focuses on the current evidence and emerging data relating to modern transfusion strategies in these patients.
Several large randomized trials and meta-analyses found no inferiority of a restrictive strategy as compared to a liberal one in red blood cell (RBC) transfusion. The storage duration of transfused RBC seems to have a minor, if any, impact on patients’ outcome. However, patients requiring massive transfusions might be an exception. The indications and benefits of plasma and platelets transfusions are less clear because robust clinical evidence is missing.
In contrast to the established evidence and practice for RBC transfusion, the limited evidence for plasma and platelets transfusions call for incorporating expert opinions and guidelines and for standardized local practice. Targeted hemostatic interventions are preferred over prophylactic fixed-ratio transfusions in terms of efficacy and avoidance of transfusion-related complications.
KeywordsTransfusion Red blood cells Platelets Fresh frozen plasma Blood components
Compliance with Ethical Standards
Conflict of Interest
Daniel Bolliger, Andreas Buser, and Kenichi A. Tanaka declare they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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