Red Blood Cell Transfusion in Critically Ill Adults

Publication Date: September 26, 2024
Last Updated: September 27, 2024

Summary of Recommendations

In critically ill patients, we recommend a restrictive RBC transfusion strategy over a permissive RBC transfusion strategy. (S, M )
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In critically ill patients with acute gastrointestinal bleeding, we recommend a restrictive RBC transfusion strategy over a permissive RBC transfusion strategy. (S, M )
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In critically ill patients with acute coronary syndrome, we suggest against a restrictive RBC transfusion strategy. (C, L )
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In critically ill patients undergoing cardiac surgery, we suggest a restrictive RBC transfusion strategy over a permissive RBC transfusion strategy in the perioperative period. (C, M )
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In critically ill patients with isolated elevation of serum troponin without other evidence of cardiac ischemia, we suggest a restrictive RBC transfusion strategy over a permissive RBC transfusion strategy. (C, VL )
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In patients with septic shock and end-organ hypoperfusion, we suggest against adding permissive RBC transfusion thresholds to usual care. (C, L )

Remarks: Studies evaluating protocol driven approaches to goal-directed therapy in septic shock were not considered in the evidence review.

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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 in Critically Ill Adults

Authoring Organization

American College of Chest Physicians

Publication Month/Year

September 26, 2024

Last Updated Month/Year

September 27, 2024

Document Type

Guideline

Country of Publication

US

Target Patient Population

Critically Ill Adults in need of a blood transfusion

Target Provider Population

Healthcare providers specializing in critical care, pulmonology, hospital medicine, and others caring for critically ill patients

Inclusion Criteria

Male, Female, Adult, Older adult

Health Care Settings

Emergency care, Hospital

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Treatment, Management

Keywords

sepsis, critically ill, red blood cell, red blood cell transfusion, blood transfusion

Source Citation

Coz Yataco AO, Soghier I, Hébert PC, Belley-Cote E, Disselkamp M, Flynn D, Halvorson K, Iaccarino JM, Lim W, Lindenmeyer CC, Miller PJ, O'Neil K, Pendleton KM, Vusse LV, Ouellette DR, Red Blood Cell Transfusion in Critically Ill Adults An American College of Chest Physicians Clinical Practice Guideline, CHEST (2024), doi: https://doi.org/10.1016/j.chest.2024.09.016.