Transfusion strategies in bleeding critically ill adults: a clinical practice guideline from the European Society of Intensive Care Medicine

Purpose To develop evidence-based clinical practice recommendations regarding transfusion practices and transfusion in bleeding critically ill adults. Methods A taskforce involving 15 international experts and 2 methodologists used the GRADE approach to guideline development. The taskforce addressed...

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Bibliographic Details
Published in:Intensive care medicine Vol. 47; no. 12; pp. 1368 - 1392
Main Authors: Vlaar, Alexander P. J., Dionne, Joanna C., de Bruin, Sanne, Wijnberge, Marije, Raasveld, S. Jorinde, van Baarle, Frank E. H. P., Antonelli, Massimo, Aubron, Cecile, Duranteau, Jacques, Juffermans, Nicole P., Meier, Jens, Murphy, Gavin J., Abbasciano, Riccardo, Müller, Marcella C. A., Lance, Marcus, Nielsen, Nathan D., Schöchl, Herbert, Hunt, Beverley J., Cecconi, Maurizio, Oczkowski, Simon
Format: Journal Article
Language:English
Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2021
Springer
Springer Nature B.V
Subjects:
Adult
Adults
Anesthesiology
Antifibrinolytic agents
Best practice
Biological products
Bleeding
Blood Transfusion
Blood transfusions
Book publishing
Clinical medicine
Clinical practice guidelines
Critical Care
Critical Care Medicine
Critical Illness - therapy
Emergency Medicine
Evidence-based medicine
Guidelines
Hemorrhage - therapy
Humans
Intensive
Medical colleges
Medical research
Medicine
Medicine & Public Health
Medicine, Experimental
Pain Medicine
Patients
Pediatrics
Pneumology/Respiratory System
Task forces
Trade and professional associations
Tranexamic acid
Canada
United Kingdom
Netherlands
Austria
United States
Plasma
Intensive care
Transfusion
Red blood cells
Critically ill
Point of care
Tranexamic acid
Guideline
Platelets
Coagulopathy
Bleeding
ISSN:0342-4642, 1432-1238, 1432-1238
Online Access:Get full text
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Summary:Purpose To develop evidence-based clinical practice recommendations regarding transfusion practices and transfusion in bleeding critically ill adults. Methods A taskforce involving 15 international experts and 2 methodologists used the GRADE approach to guideline development. The taskforce addressed three main topics: transfusion support in massively and non-massively bleeding critically ill patients (transfusion ratios, blood products, and point of care testing) and the use of tranexamic acid. The panel developed and answered structured guideline questions using population, intervention, comparison, and outcomes (PICO) format. Results The taskforce generated 26 clinical practice recommendations (2 strong recommendations, 13 conditional recommendations, 11 no recommendation), and identified 10 PICOs with insufficient evidence to make a recommendation. Conclusions This clinical practice guideline provides evidence-based recommendations for the management of massively and non-massively bleeding critically ill adult patients and identifies areas where further research is needed.
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ISSN:0342-4642
1432-1238
1432-1238
DOI:10.1007/s00134-021-06531-x