Red Blood Cell Transfusion

Publication Date: October 12, 2023
Last Updated: January 19, 2024

Recommendations for Adults

For hospitalized adult patients who are hemodynamically stable, the international panel recommends a restrictive RBC transfusion strategy in which the transfusion is considered when the hemoglobin concentration is less than 7 g/dL. (S, M)
In accordance with the restrictive strategy threshold used in most of the trials for subgroups of patients, clinicians may choose a threshold of 7.5 g/dL for patients undergoing cardiac surgery and 8 g/dL for patients undergoing orthopedic surgery or those with preexisting cardiovascular disease.
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For hospitalized adult patients, the panel suggests a restrictive RBC transfusion strategy in which transfusion is considered when the hemoglobin concentration is less than 7 g/dL in those with hematologic and oncologic disorders. (C, L)
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Recommendations for Children

For critically ill children and hospitalized children at risk of critical illness who are hemodynamically stable and without a transfusion-dependent hemoglobinopathy, cyanotic cardiac condition, or severe hypoxemia, the international panel recommends a restrictive transfusion strategy in which a transfusion is considered when the hemoglobin level is less than 7 g/dL compared with one of less than 9.5 g/dL. (S, M)
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The international panel suggests considering a transfusion threshold for hemodynamically stable children with congenital heart disease that is based on the cardiac abnormality and stage of surgical repair: 7 g/dL (biventricular repair), 9 g/dL (single-ventricle palliation), or 7 to 9 g/dL (uncorrected congenital heart disease). (C, L)
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Recommendation Grading

Disclaimer

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

Overview

Title

Red Blood Cell Transfusion

Authoring Organization

Publication Month/Year

October 12, 2023

Last Updated Month/Year

October 13, 2023

Document Type

Guideline

Country of Publication

Global

Document Objectives

To provide recommendations for use of red blood cell transfusion in adults and children.

Target Patient Population

Adults and children in need of red blood cell transfusions

Target Provider Population

Transfusion medicine specialists and allied clinicians caring for adults and children in need of red blood cell transfusions

Inclusion Criteria

Male, Female, Adolescent, Adult, Child, Infant, Older adult

Health Care Settings

Ambulatory, Emergency care, Hospital, Outpatient, Operating and recovery room

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Management

Diseases/Conditions (MeSH)

D001803 - Blood Transfusion

Keywords

blood transfusions, red blood cell, red blood cell transfusion, blood transfusion

Source Citation

Carson JL, Stanworth SJ, Guyatt G, et al. Red Blood Cell Transfusion: 2023 AABB International Guidelines. JAMA. Published online October 12, 2023. doi:10.1001/jama.2023.12914