Decisions to transfuse should be based on assessment of an individual patient including their underlying cause of anemia. There is high quality evidence that demonstrates a lack of benefit and, in some cases, harm to patients transfused to achieve an arbitrary transfusion threshold. If necessary, transfuse only the minimum number of units required instead of a liberal transfusion strategy. Risks of red blood cell transfusions include allergy, fever, infections, volume overload and hemolysis.
Sources:
Callum J, et al. Bloody easy 3, blood transfusions, blood alternatives and transfusion reactions, a guide to transfusion medicine. 3rd ed. Toronto (ON): Sunnybrook and Women’s College Health Sciences Centre; 2011. PMID: 22751760.
Choosing Wisely Canada. Canadian Society of Internal Medicine: Five Things Physicians and Patients Should Question [Internet]. 2014 [cited 2014 Aug 26].
Carson JL, et al. Red blood cell transfusion: a clinical practice guideline from the AABB*. Ann. Intern. Med. Jul 3 2012;157(1):49-58. PMID: 22751760.
Hebert PC, et al. A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. Transfusion Requirements in Critical Care Investigators, Canadian Critical Care Trials Group. N. Engl. J. Med. Feb 11 1999;340(6):409-417. PMID: 9971864.
Hicks LK, et al. The ASH Choosing Wisely(R) campaign: five hematologic tests and treatments to question. Blood. Dec 5 2013;122(24):3879-3883. PMID: 24307720.
Related Resources:
Toolkit: Why Give Two When One Will Do – A toolkit for reducing unnecessary red blood cell transfusions in hospitals