New Guidelines Recommend a Restrictive Red Blood Cell Transfusion Strategy for Most Critically Ill Patients

The CHEST guidelines support restrictive practices for patients with isolated elevated troponin and discourage permissive strategies for those with septic shock.

Sponsoring Organization: American College of Chest Physicians (CHEST)

Background

This is the first guideline from CHEST that is focused on transfusion of red blood cells (RBC) in critically ill adults, excluding those with neurological injury or trauma. It complements other guidelines from the Critical Care Societies Collaborative. In this document, a “restrictive” threshold generally means a hemoglobin level of 7 to 8 g/dL, and a “permissive” threshold generally means a level of 8.5 to 10.0 g/dL.

Key Recommendations

Use a restrictive transfusion strategy for critically ill patients, including patients with acute gastrointestinal bleeding, but excluding those with hemodynamic instability from hemorrhage (strong recommendation).
Consider a restri…

Reviewing Author

Patricia Kritek, MD

Disclosures

Editorial BoardsATS Scholar

Patricia Kritek, MD

Disclosures

Editorial BoardsATS Scholar

New Guidelines Recommend a Restrictive Red Blood Cell Transfusion Strategy for Most Critically Ill Patients

Topics

Background

Key Recommendations

Reviewing Author