Red Blood Cell Transfusion

Abstract

Letters20 November 2012Red Blood Cell TransfusionJeffrey L. Carson, MD, Sunil V. Rao, MD, and Louis M. Katz, MDJeffrey L. Carson, MDFrom UMDNJ–Robert Wood Johnson Medical School, New Brunswick, NJ 08903; The Duke Clinical Research Institute, Durham, NC 27705; and Americas Blood Centers, Washington, DC 20005.Search for more papers by this author, Sunil V. Rao, MDFrom UMDNJ–Robert Wood Johnson Medical School, New Brunswick, NJ 08903; The Duke Clinical Research Institute, Durham, NC 27705; and Americas Blood Centers, Washington, DC 20005.Search for more papers by this author, and Louis M. Katz, MDFrom UMDNJ–Robert Wood Johnson Medical School, New Brunswick, NJ 08903; The Duke Clinical Research Institute, Durham, NC 27705; and Americas Blood Centers, Washington, DC 20005.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-157-10-201211200-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate the opportunity to reiterate that our guideline states that transfusion should be considered in specific patient subgroups when the nadir hemoglobin reaches 7 to 8 g/dL. In addition, the decision to transfuse should be influenced by signs and symptoms. We based our recommendations on the best available evidence: 19 randomized clinical trials in 6264 patients. However, clinical trials provide an average effect in the population studied. Thus, it is likely that some patients need more or less blood to improve outcomes.The “conundrum” is what clinical factors should influence the “routine titrated” transfusion decision. The largest ...