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Transfusion Requirements in Anesthesia and Intensive Care

  • Critical Care Anesthesia (BS Rasmussen, Section Editor)
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Abstract

Purpose of Review

Allogeneic blood products are commonly used in perioperative and critically ill patients. This review focuses on the current evidence and emerging data relating to modern transfusion strategies in these patients.

Recent Findings

Several large randomized trials and meta-analyses found no inferiority of a restrictive strategy as compared to a liberal one in red blood cell (RBC) transfusion. The storage duration of transfused RBC seems to have a minor, if any, impact on patients’ outcome. However, patients requiring massive transfusions might be an exception. The indications and benefits of plasma and platelets transfusions are less clear because robust clinical evidence is missing.

Summary

In contrast to the established evidence and practice for RBC transfusion, the limited evidence for plasma and platelets transfusions call for incorporating expert opinions and guidelines and for standardized local practice. Targeted hemostatic interventions are preferred over prophylactic fixed-ratio transfusions in terms of efficacy and avoidance of transfusion-related complications.

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Authors and Affiliations

  1. Department for Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine, and Pain Therapy, University Hospital Basel, Spitalstrasse 21, CH-4031, Basel, Switzerland

    Daniel Bolliger

  2. Regional Blood Transfusion Service, Swiss Red Cross, Basel, and Department of Hematology, University Hospital Basel, Basel, Switzerland

    Andreas Buser

  3. Department of Anesthesiology, Cardiothoracic Anesthesia Division, University of Maryland, Suite S8D12, Baltimore, MD, USA

    Kenichi A. Tanaka

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  1. Daniel Bolliger
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Correspondence to Daniel Bolliger.

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Bolliger, D., Buser, A. & Tanaka, K.A. Transfusion Requirements in Anesthesia and Intensive Care. Curr Anesthesiol Rep 9, 194–201 (2019). https://doi.org/10.1007/s40140-019-00320-5

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