Choosing Wisely:

Avoid transfusions of red blood cells for arbitrary hemoglobin or hematocrit thresholds and in the absence of symptoms or active coronary disease, heart failure, or stroke.

Rationale and Comments: The AABB recommends adhering to a restrictive transfusion strategy (7 to 8 g/dL) in hospitalized, stable patients. The AABB suggests that transfusion decisions be influenced by symptoms as well as hemoglobin concentration. According to a National Institutes of Health Consensus Conference, no single criterion should be used as an indication for red cell component therapy. Instead, multiple factors related to the patient’s clinical status and oxygen delivery needs should be considered.
Sponsoring Organizations:
  • Society of Hospital Medicine (Adult)
  • Sources:
  • AABB guidelines
  • Disciplines:
  • Hematologic
  • References: • Red blood cell transfusion: a clinical practice guideline from the AABB. Ann Intern Med. 2012;157(1):49-58.
    • Consensus conference. Perioperative red blood cell transfusion. JAMA. 1988;260(18):2700-3.
    • AABB. Advancing Transfusion and Cellular Therapies Worldwide. AABB name change. who/Pages/namechange.aspx.

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