期刊
TRANSFUSION MEDICINE REVIEWS
卷 25, 期 3, 页码 232-246出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.tmrv.2011.02.001
关键词
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类别
资金
- Society for the Advancement of Blood Management (SABM
- Milwaukee, WI)
- Medical Society for Blood Management (Laxenburg, Austria)
- Amgen, Inc
- Vifor International AG
- CSL Behring GmbH
- Novo Nordisk A/S
- Novo Nordisk, Inc
- Australian Red Cross Blood Service
- Baxter Healthcare Corporation
- B. Braun Melsungen AG
- Fresenius Kabi Deutschland GmbH
- Bayer
- Novartis
- Novo Nordisk
- OrthoBiotech
- Pfizer
- ZymoGenetics
- Federal Austrian Ministry of Health
- Western Australian Department of Health
- NovoNordisk
- Advisory Committee and Board Member
- University of Zurich (Zurich, Switzerland)
- Research Award Center for Zurich Integrative Human Physiology (Zurich, Switzerland)
- Swiss National Science Foundation (Berne, Switzerland) [SPUM 33CM30_124117]
- European Society of Anaesthesiology (ESA
- Brussels, Belgium)
- Swiss Society of Anesthesiology and Reanimation (SGAR
- Berne, Switzerland),
- Swiss Foundation for Anesthesia Research (Zurich, Switzerland)
- Swiss Life Foundation (Zurich, Switzerland)
- Bundesprogramm Chancengleichheit (Berne, Switzerland)
- Stiftung fur Staublungen-Forschung (Zurich, Switzerland)
- B. Braun (Sempach, Switzerland)
- CSL Behring (Berne, Switzerland)
- Vifor SA (Villars-sur-Glane, Switzerland)
- UBS (Zurich, Switzerland)
- Novo Nordisk A/S (Bagsyard, Denmark)
- NHLBI
- NIH
An international multidisciplinary panel of 15 experts reviewed 494 published articles and used the RAND/UCLA Appropriateness Method to determine the appropriateness of allogeneic red blood cell (RBC) transfusion based on its expected impact on outcomes of stable nonbleeding patients in 450 typical inpatient medical, surgical, or trauma scenarios. Panelists rated allogeneic RBC transfusion as appropriate in 53 of the scenarios (11.8%), inappropriate in 267 (59.3%), and uncertain in 130 (28.9%). Red blood cell transfusion was most often rated appropriate (81%) in scenarios featuring patients with hemoglobin (Hb) level 7.9 g/dL or less, associated comorbidities, and age older than 65 years. Red blood cell transfusion was rated inappropriate in all scenarios featuring patients with Hb level 10 g/dL or more and in 71.3% of scenarios featuring patients with Hb level 8 to 9.9 g/dL. Conversely, no scenario with patient's Hb level of 8 g/dL or more was rated as appropriate. Nearly one third of all scenarios were rated uncertain, indicating the need for more research. The observation that allogeneic RBC transfusions were rated as either inappropriate or uncertain in most scenarios in this study supports a more judicious transfusion strategy. In addition, the large number of scenarios in which RBC transfusions were rated as uncertain can serve as a road map to identify areas in need of further investigation. (C) 2011 Elsevier Inc. All rights reserved.
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