Transcript PowerPoint Slides

From the Publishers of
Is that Hemoglobin High
Enough?
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A Difference of Opinion
How high should Hgb be in the ICU and postoperative patient?
 LIBERAL (higher Hgb goals)
Hgb 10-12
 RESTRICTIVE (transfusion approach)
 Hgb 7-9

Doesn’t the LIBERAL approach deliver more O2 to the tissues and
improve outcome?
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Carson JL, Terrin ML, Noveck H, et al. Liberal or restrictive transfusion in high-risk
patients after hip surgery. N Engl J Med. 2011;365:2453-62.
Hebert PC, Wells G, Blajchman MA, et al. A multicenter, randomized, controlled
clinical trial of transfusion requirements in critical care. N Engl J Med
1999;340:409-417.
Red Blood Cell Transfusion: A Clinical Practice Guideline
From the AABB*
 Restrictive transfusion in hospitalized stable patient
 Transfuse if Hgb < 7-8
 Restrictive transfusion in hospitalized patient with CV
disease
 Transfuse if symptomatic or Hgb < 8
 Transfusion decisions guided by symptoms and Hgb
 No data for guide in hospitalized stable ACS patient
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Liberal or Restrictive Transfusion in High-Risk Patients after
Hip Surgery
 Patients > age 50
 Known or at risk for cardiovascular disease
 Hip fracture surgery
 Liberal: transfuse if Hgb< 10
 Restrictive: transfuse if anemia symptoms or Hgb<8
 No difference in:
 Mortality
 Morbidity
 Functional capacity at 60 days postop
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