Red Blood Cell Transfusion
Authors: Jeffrey L. Carson, Sunil V. Rao, Louis M. Katz
Journal: Annals of Internal Medicine (2012)

Letters20 November 2012Red Blood Cell TransfusionJeffrey L. Carson, MD, Sunil V. Rao, MD, and Louis M. Katz, MDJeffrey L. Carson, MDFrom UMDNJ–Robert Wood Johnson Medical School, New Brunswick, NJ 08903; The Duke Clinical Research Institute, Durham, NC 27705; and Americas Blood Centers, Washington, DC 20005.Search for more papers by this author, Sunil V. Rao, MDFrom UMDNJ–Robert Wood Johnson Medical School, New Brunswick, NJ 08903; The Duke Clinical Research Institute, Durham, NC 27705; and Americas Blood Centers, Washington, DC 20005.Search for more papers by this author, and Louis M. Katz, MDFrom UMDNJ–Robert Wood Johnson Medical School, New Brunswick, NJ 08903; The Duke Clinical Research Institute, Durham, NC 27705; and Americas Blood Centers, Washington, DC 20005.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-157-10-201211200-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate the opportunity to reiterate that our guideline states that transfusion should be considered in specific patient subgroups when the nadir hemoglobin reaches 7 to 8 g/dL. In addition, the decision to transfuse should be influenced by signs and symptoms. We based our recommendations on the best available evidence: 19 randomized clinical trials in 6264 patients. However, clinical trials provide an average effect in the population studied. Thus, it is likely that some patients need more or less blood to improve outcomes.The “conundrum” is what clinical factors should influence the “routine titrated” transfusion decision. The largest ...References1. Carson JL, Terrin ML, Noveck H, Sanders DW, Chaitman BR, Rhoads GG, et al; FOCUS Investigators. Liberal or restrictive transfusion in high-risk patients after hip surgery. N Engl J Med. 2011;365:2453-62. [PMID: 22168590] CrossrefMedlineGoogle 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. Vuille-Lessard E, Boudreault D, Girard F, Ruel M, Chagnon M, Hardy JF. Red blood cell transfusion practice in elective orthopedic surgery: a multicenter cohort study. Transfusion. 2010;50:2117-24. [PMID: 20492612] CrossrefMedlineGoogle Scholar4. Moscucci M, Ricciardi M, Eagle KA, Kline E, Bates ER, Werns SW, et al. Frequency, predictors, and appropriateness of blood transfusion after percutaneous coronary interventions. Am J Cardiol. 1998;81:702-7. [PMID: 9527078] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Jeffrey L. Carson, MD; Sunil V. Rao, MD; Louis M. Katz, MDAffiliations: From UMDNJ–Robert Wood Johnson Medical School, New Brunswick, NJ 08903; The Duke Clinical Research Institute, Durham, NC 27705; and Americas Blood Centers, Washington, DC 20005.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-3065. 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 Harvey G. Klein and Charles Natanson Metrics Cited byBlood Transfusions for Emergency Laparotomies in General Surgery 20 November 2012Volume 157, Issue 10Page: 754-755KeywordsClinical trialsHemoglobinRandomized trialsRed blood cellsResearch laboratoriesResuscitationSigns and symptomsTachycardiaVentilators ePublished: 20 November 2012 Issue Published: 20 November 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...