When to transfuse: Red blood cell and platelet transfusion thresholds in clinical practice

C E Menard; M Seftel; A Ponnampalam; R Zarychanski

doi:10.7196/SAMJ.2019.v109i11.14317

Continuing Medical Education

When to transfuse: Red blood cell and platelet transfusion thresholds in clinical practice

C E Menard, M Seftel, A Ponnampalam, R Zarychanski

Abstract

Blood component transfusion is a frequently prescribed intervention in healthcare that depends on the availability of a limited and expensive resource. The transfusion of blood products may be life-saving, but it is not without risk. Society guidelines and clinical trials guide transfusion decisions regarding transfusion thresholds, as well as the appropriateness of prophylactic v. therapeutic transfusion strategies. This review provides a practical and evidence-informed approach to the transfusion of red blood cells and platelets in commonly encountered clinical settings.

Authors' affiliations

C E Menard, Section of Hematology and Medical Oncology, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg; and Department of Medical Oncology and Hematology, CancerCare Manitoba, Winnipeg, Canada

M Seftel, Division of Hematology, Department of Medicine, University of British Columbia, Vancouver, Canada

A Ponnampalam, Section of Hematology and Medical Oncology, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg; and Department of Medical Oncology and Hematology, CancerCare Manitoba, Winnipeg, Canada

R Zarychanski, Section of Hematology and Medical Oncology, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg; Department of Medical Oncology and Hematology, CancerCare Manitoba, Winnipeg; and Section of Critical Care, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada