Clinical practice guideline: red blood cell transfusion in adult trauma and critical care.
OBJECTIVE
To develop a clinical practice guideline for red blood cell transfusion in adult trauma and critical care.


METHODS
Meetings, teleconferences and electronic-based communication to achieve grading of the published evidence, discussion and consensus among the entire committee members.


METHODS
This practice management guideline was developed by a joint taskforce of EAST (Eastern Association for Surgery of Trauma) and the American College of Critical Care Medicine (ACCM) of the Society of Critical Care Medicine (SCCM). We performed a comprehensive literature review of the topic and graded the evidence using scientific assessment methods employed by the Canadian and U.S. Preventive Task Force (Grading of Evidence, Class I, II, III; Grading of Recommendations, Level I, II, III). A list of guideline recommendations was compiled by the members of the guidelines committees for the two societies. Following an extensive review process by external reviewers, the final guideline manuscript was reviewed and approved by the EAST Board of Directors, the Board of Regents of the ACCM and the Council of SCCM.


RESULTS
Key recommendations are listed by category, including (A) Indications for RBC transfusion in the general critically ill patient; (B) RBC transfusion in sepsis; (C) RBC transfusion in patients at risk for or with acute lung injury and acute respiratory distress syndrome; (D) RBC transfusion in patients with neurologic injury and diseases; (E) RBC transfusion risks; (F) Alternatives to RBC transfusion; and (G) Strategies to reduce RBC transfusion.


CONCLUSIONS
Evidence-based recommendations regarding the use of RBC transfusion in adult trauma and critical care will provide important information to critical care practitioners.
Napolitano
Lena M
LM
lenan@med.umich.edu
Kurek
Stanley
S
Luchette
Fred A
FA
Corwin
Howard L
HL
Barie
Philip S
PS
Tisherman
Samuel A
SA
Hebert
Paul C
PC
Anderson
Gary L
GL
Bard
Michael R
MR
Bromberg
William
W
Chiu
William C
WC
Cipolle
Mark D
MD
Clancy
Keith D
KD
Diebel
Lawrence
L
Hoff
William S
WS
Hughes
K Michael
KM
Munshi
Imtiaz
I
Nayduch
Donna
D
Sandhu
Rovinder
R
Yelon
Jay A
JA
D000328:Adult; D003422:Critical Care; D016638:Critical Illness / Q000628:therapy*; D017707:Erythrocyte Transfusion; D006801:Humans; D014947:Wounds and Injuries / Q000628:therapy*