Red Blood Cell Transfusion
Authors: Harvey G. Klein, Charles Natanson
Journal: Annals of Internal Medicine (2012)

Letters20 November 2012Red Blood Cell TransfusionHarvey G. Klein, MD and Charles Natanson, MDHarvey G. Klein, MDFrom National Institutes of Health, Bethesda, MD 20892.Search for more papers by this author and Charles Natanson, MDFrom National Institutes of Health, Bethesda, MD 20892.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-157-10-201211200-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Carson and colleagues' guideline (1) for the AABB of adhering to a “restrictive” transfusion threshold that relies on a hemoglobin level of 7 to 8 g/dL or less for hemodynamically stable patients is well-intentioned but problematic. We are not surprised that the editorial (2) accompanying this proposed guideline arrives at a different conclusion—one that we agree with. We also believe that transfusion thresholds should be titrated on the basis of many important individual patient laboratory and physiologic variables. Why the disparity after considering the same decade of clinical experience and trial data? The weaknesses of the most ...References1. Carson JL, Grossman BJ, Kleinman S, Tinmouth AT, Marques MB, Fung MK, et al; Clinical Transfusion Medicine Committee of the AABB. Red blood cell transfusion: a clinical practice guideline from the AABB. Ann Intern Med. 2012;157:49-58. [PMID: 22751760] LinkGoogle Scholar2. Vincent JL. Indications for blood transfusions: too complex to base on a single number? [Editorial]. Ann Intern Med. 2012;157:71-2. [PMID: 22751765] LinkGoogle Scholar3. Deans KJ, Minneci PC, Suffredini AF, Danner RL, Hoffman WD, Ciu X, et al. Randomization in clinical trials of titrated therapies: unintended consequences of using fixed treatment protocols. Crit Care Med. 2007;35:1509-16. [PMID: 17440420] CrossrefMedlineGoogle Scholar4. Blood Supply: Transfusion-Associated Risks. Report to the Ranking Minority Member Committee on Commerce, House of Representatives. GAO/PEMD-97-2. Washington DC: U.S. General Accounting Office; 1997. Google Scholar5. Klein HG. Comparative effectiveness research: welcome to the real world [Editorial]. Transfusion. 2012;52:1162-4. [PMID: 22686529] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Harvey G. Klein, MD; Charles Natanson, MDAffiliations: From National Institutes of Health, Bethesda, MD 20892.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRed Blood Cell Transfusion: A Clinical Practice Guideline From the AABB* Jeffrey L. Carson , Brenda J. Grossman , Steven Kleinman , Alan T. Tinmouth , Marisa B. Marques , Mark K. Fung , John B. Holcomb , Orieji Illoh , Lewis J. Kaplan , Louis M. Katz , Sunil V. Rao , John D. Roback , Aryeh Shander , Aaron A.R. Tobian , Robert Weinstein , Lisa Grace Swinton McLaughlin , Benjamin Djulbegovic , and Indications for Blood Transfusions: Too Complex to Base on a Single Number? Jean-Louis Vincent Red Blood Cell Transfusion Jeffrey L. Carson , Sunil V. Rao , and Louis M. Katz Metrics Cited byBlood-transfusion decisions not simpleDoes prolonged storage of red blood cells cause harm? 20 November 2012Volume 157, Issue 10Page: 753-754KeywordsBloodBlood transfusionClinical trialsConflicts of interestHemoglobinPopulation statisticsRed blood cellsResearch laboratoriesTreatment guidelines ePublished: 20 November 2012 Issue Published: 20 November 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...