Transfusion thresholds and other strategies for guiding red blood cell transfusion

作者：Jeffrey L. Carson, Simon Stanworth, Jane A Dennis, Dean Fergusson, Monica B. Pagano, Nareg H. Roubinian, Alexis F. Turgeon, Stacey L. Valentine, Marialena Trivella, Carolyn Dorée, Paul C. Hébert · 发表于：Cochrane Database of Systematic Reviews · 年份：2025 · DOI：10.1002/14651858.cd002042.pub6 · 被引用次数：11 · 研究领域：Blood transfusion and management、Trauma, Hemostasis, Coagulopathy, Resuscitation、Blood groups and transfusion

BACKGROUND: The optimal haemoglobin threshold for use of red blood cell (RBC) transfusions in anaemic patients remains an active area of research. Blood is a limited resource, and there are concerns about risks, including transmitted infections. If a liberal transfusion strategy does not improve clinical outcomes, or if it is equivalent, then adopting a more restrictive approach should be recognised as the standard of care. OBJECTIVES: The aim of this review update was to compare 30-day mortality and other clinical outcomes for participants randomised to restrictive versus liberal red blood cell (RBC) transfusion thresholds (triggers) for all clinical conditions. The restrictive transfusion threshold uses a lower haemoglobin concentration as a threshold for transfusion (most commonly, 7.0 g/dL to 8.0 g/dL), and the liberal transfusion threshold uses a higher haemoglobin concentration to direct transfusion (most commonly, 9.0 g/dL to 10.0 g/dL). Increasingly, investigators are considering other strategies including physiological triggers (i.e. central venous oxygen saturation), alone or in combination with such thresholds, to determine when a transfusion is indicated, so it is important to assess this growing body of evidence in tandem. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, Transfusion Evidence Library, Web of Science Conference Proceedings Citation Index, trial registries and PubMed on 14 October 2024. We checked reference lists of published reviews and papers...