Blood products are a limited resource. Blood transfusion is associated with adverse effects, including transfusion reactions, immunosuppression, lung injury, and circulatory overload. In the context of stable patients with burn injuries, who are not actively bleeding or with active myocardial ischaemia, the current evidence supports a restrictive transfusion trigger to maintain haemoglobin above 70g/l. Unnecessary transfusions can also be avoided by ordering and infusing one unit of red blood cells at a time (with interval blood tests to confirm indication for a further unit), rather than ordering two units immediately.
For more information:
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Palmieri TL, Holmes JH, Arnoldo B, et al. Restrictive Transfusion Strategy Is More Effective in Massive Burns: Results of the TRIBE Multicenter Prospective Randomized Trial. Mil Med. 2019; 184(Suppl 1):11-15. PMID: 30371811.
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