Red blood cell transfusion: a clinical practice guideline from the AABB.
The merit of the recommendations formulated by the AABB is that they are based on a systematic review of randomized clinical trials (RCTs) evaluating transfusion thresholds, contrary to numerous guidelines based on less stringent material such as retrospective trials, experimental studies in animals or “expert opinion”. The number of RCTs available for different patient populations is growing but remains limited. Thus, the AABB was unable to answer all the questions submitted to the expert panel. In particular, clinicians must recognize that, for hospitalized, hemodynamically stable patients with an acute coronary syndrome, there is NO good answer as to what constitutes an appropriate transfusion trigger. Obviously, more RCTs on transfusion thresholds in different patient populations are required but, for the time being, the AABB recommendations are the best available and should be read by all clinicians likely to transfuse patients.
– Jean-François Hardy