Guideline Tightens Transfusion Criteria

With a growing evidence base suggesting that patients with hemoglobin levels at 8 g/dL or higher may not benefit from transfusion, a new guideline from the American Association of Blood Banks (AABB) suggests that physicians use a lower hemoglobin threshold and a patient's symptoms to determine when to give a blood transfusion.

About 44 000 units of blood are administered to patients each day in the United States, according to the AABB, with wide variation in transfusion practices across the country. Last year, the Department of Health and Human Services Advisory Committee on Blood Safety and Availability concluded that the variability suggested there may be excessive and sometimes inappropriate use of blood transfusions. The committee also noted that the growing population of older adults may further strain the US blood supply in years to come, requiring more judicious use (http://tinyurl.com/7qfv8b8). The committee noted the need for additional data about blood use and clinical outcomes and encouraged efforts to promote evidence-based practices.