Update in critical care for the nephrologist: transfusion in nonhemorrhaging critically ill patients Journal Article

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Authors: Afshar, M; Netzer, G
Article Title: Update in critical care for the nephrologist: transfusion in nonhemorrhaging critically ill patients
Abstract: A growing number of guidelines and recommendations advocate a restrictive transfusion strategy. Strong evidence exists that a hemoglobin threshold of less than 7 g/dL conserves resources and may improve outcomes in critically ill patients and that platelet counts greater than 10,000/muL are well tolerated. Patients with coronary artery disease can be safely managed with a restrictive transfusion strategy, utilizing a hemoglobin threshold of less than 7 or 8 g/dL; a threshold of less than 8 g/dL can be applied to patients with acute coronary syndromes. In the absence of coagulopathy with bleeding or high risk for bleeding, plasma transfusion should be withheld. Complications from transfusion are significant and previously under-recognized immunologic complications pose a more serious threat than infections. Erythropoietin and iron administration do not reduce transfusion needs in the critically ill. Interventions to reduce blood loss and educate clinicians are successful in reducing transfusion requirements.
Journal Title: Advances in chronic kidney disease
Volume: 20
Issue: 1
ISSN: 1548-5609; 1548-5595
Publisher: Unknown  
Journal Place: United States
Date Published: 2013
Start Page: 30
End Page: 38
Language: eng
DOI/URL:

10.1053/j.ackd.2012.10.007
Notes: CI: Published by Elsevier Inc.; GR: K12 RR023250/RR/NCRR NIH HHS/United States; JID: 101209214; 2012/07/10 [received]; 2012/10/19 [revised]; 2012/10/22 [accepted]; ppublish