An international panel of experts within the Association for the Advancement of Blood and Biotherapeutics (AABB) has provided updated recommendations for red blood cell transfusions in children and adults. Blood transfusions in hemodynamically stable adult patients should be performed according to strict indications.
AABB experts have updated recommendations for red blood cell transfusions in children and adults. The document was published in the journal JAMA Network.
When managing hospitalized hemodynamically stable adult patients, blood transfusion should be performed only when strictly indicated: when the hemoglobin concentration decreases below 7 g/dL. A threshold of 7.5 g/dL may be used for patients who have undergone cardiac surgery and 8 g/dL for patients who have undergone orthopedic surgery or with underlying cardiovascular disease.
In hospitalized adult patients with hematological and oncological diseases, it is recommended to undergo blood transfusion when the hemoglobin level decreases below 7 g/dL.
Hemodynamically stable children in critical condition or at high risk of developing it, in the absence of hemoglobinopathy, cyanotic heart defects or severe hypoxemia, are recommended to undergo blood transfusion with a hemoglobin concentration below 7 g/dL.
In hemodynamically stable children with congenital heart disease, the hemoglobin level at which red blood cell transfusion is indicated depends on the pathology and surgical correction of the defect. In case of surgery on both ventricles, the indication for blood transfusion is a hemoglobin level of 7 g/dl. If reconstructive surgery was performed on only one ventricle, 9 g/dL. For uncorrected congenital heart disease, the threshold is 7–9 g/dL.
When deciding whether to give a blood transfusion to a patient, it is recommended that the patient’s general clinical condition and treatment alternatives to blood transfusion be taken into account.