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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| Vydáno v: | Intensive care medicine Ročník 47; číslo 12; s. 1368 - 1392 |
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| Hlavní autoři: | , , , , , , , , , , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
| Vydáno: |
Berlin/Heidelberg
Springer Berlin Heidelberg
01.12.2021
Springer Springer Nature B.V |
| Témata: | |
| ISSN: | 0342-4642, 1432-1238, 1432-1238 |
| On-line přístup: | Získat plný text |
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| Abstract | 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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| AbstractList | PurposeTo develop evidence-based clinical practice recommendations regarding transfusion practices and transfusion in bleeding critically ill adults.MethodsA 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.ResultsThe 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.ConclusionsThis 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. 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. 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. To develop evidence-based clinical practice recommendations regarding transfusion practices and transfusion in bleeding critically ill adults. 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. 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. 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. To develop evidence-based clinical practice recommendations regarding transfusion practices and transfusion in bleeding critically ill adults. 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. 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. 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. To develop evidence-based clinical practice recommendations regarding transfusion practices and transfusion in bleeding critically ill adults.PURPOSETo develop evidence-based clinical practice recommendations regarding transfusion practices and transfusion in bleeding critically ill adults.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.METHODSA 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.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.RESULTSThe 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.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.CONCLUSIONSThis 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. |
| Audience | Academic |
| Author | Aubron, Cecile Vlaar, Alexander P. J. Juffermans, Nicole P. Hunt, Beverley J. Schöchl, Herbert Nielsen, Nathan D. Dionne, Joanna C. Duranteau, Jacques Müller, Marcella C. A. Cecconi, Maurizio de Bruin, Sanne Oczkowski, Simon Wijnberge, Marije van Baarle, Frank E. H. P. Murphy, Gavin J. Raasveld, S. Jorinde Antonelli, Massimo Meier, Jens Abbasciano, Riccardo Lance, Marcus |
| Author_xml | – sequence: 1 givenname: Alexander P. J. orcidid: 0000-0002-3453-7186 surname: Vlaar fullname: Vlaar, Alexander P. J. email: a.p.vlaar@amsterdamumc.nl organization: Department of Intensive Care Medicine, Amsterdam UMC, Location AMC – sequence: 2 givenname: Joanna C. surname: Dionne fullname: Dionne, Joanna C. organization: Department of Medicine, McMaster University, The Guidelines in Intensive Care Development and Evaluation (GUIDE) Group, He Research Institute St. Joseph’s Healthcare Hamilton, Department of Health Research Methods, Evidence, and Impact, McMaster University, Division of Gastroenterology, McMaster University – sequence: 3 givenname: Sanne surname: de Bruin fullname: de Bruin, Sanne organization: Department of Intensive Care Medicine, Amsterdam UMC, Location AMC – sequence: 4 givenname: Marije surname: Wijnberge fullname: Wijnberge, Marije organization: Department of Intensive Care Medicine, Amsterdam UMC, Location AMC, Department of Anaesthesiology, Amsterdam UMC, Location AMC – sequence: 5 givenname: S. Jorinde surname: Raasveld fullname: Raasveld, S. Jorinde organization: Department of Intensive Care Medicine, Amsterdam UMC, Location AMC – sequence: 6 givenname: Frank E. H. P. surname: van Baarle fullname: van Baarle, Frank E. H. P. organization: Department of Intensive Care Medicine, Amsterdam UMC, Location AMC – sequence: 7 givenname: Massimo surname: Antonelli fullname: Antonelli, Massimo organization: Department of Anaesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario A.Gemelli IRCCS, Istituto di Anaesthesiology e Rianimazione Università Cattolica del Sacro Cuore – sequence: 8 givenname: Cecile surname: Aubron fullname: Aubron, Cecile organization: Department of Intensive Care Medicine, Centre Hospitalier Régional et Universitaire de Brest, site La Cavale Blanche, Université de Bretagne Occidentale – sequence: 9 givenname: Jacques surname: Duranteau fullname: Duranteau, Jacques organization: Department of Anaesthesia and Intensive Care, Hôpitaux Universitaires Paris Sud (HUPS) – sequence: 10 givenname: Nicole P. surname: Juffermans fullname: Juffermans, Nicole P. organization: Laboratory of Experimental Intensive Care and Anesthesiology, Amsterdam University Medical Center, OLVG Hospital – sequence: 11 givenname: Jens surname: Meier fullname: Meier, Jens organization: Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Kepler University – sequence: 12 givenname: Gavin J. surname: Murphy fullname: Murphy, Gavin J. organization: NIHR Leicester Biomedical Research Centre–Cardiovascular, Department of Cardiovascular Sciences, College of Life Sciences, University of Leicester – sequence: 13 givenname: Riccardo surname: Abbasciano fullname: Abbasciano, Riccardo organization: NIHR Leicester Biomedical Research Centre–Cardiovascular, Department of Cardiovascular Sciences, College of Life Sciences, University of Leicester – sequence: 14 givenname: Marcella C. A. surname: Müller fullname: Müller, Marcella C. A. organization: Department of Intensive Care Medicine, Amsterdam UMC, Location AMC – sequence: 15 givenname: Marcus surname: Lance fullname: Lance, Marcus organization: Department of Anesthesiology, Intensive Care and Perioperative Medicine, Hamad Medical Corporation – sequence: 16 givenname: Nathan D. surname: Nielsen fullname: Nielsen, Nathan D. organization: Division of Pulmonary, Critical Care, and Sleep Medicine, University of New Mexico School of Medicine – sequence: 17 givenname: Herbert surname: Schöchl fullname: Schöchl, Herbert organization: Department of Anaesthesiology and Intensive Care Medicine, AUVA Trauma Centre Salzburg, Academic Teaching Hospital of the Paracelsus Medical University, Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Trauma Research Centre – sequence: 18 givenname: Beverley J. surname: Hunt fullname: Hunt, Beverley J. organization: Thrombosis and Haemophilia Centre, Guys & St Thomas’ NHS Foundation Trust – sequence: 19 givenname: Maurizio surname: Cecconi fullname: Cecconi, Maurizio organization: Department of Anaesthesia and Intensive Care Medicine, Humanitas Clinical and Research Centre-IRCCS, Humanitas University – sequence: 20 givenname: Simon surname: Oczkowski fullname: Oczkowski, Simon organization: Department of Medicine, McMaster University, The Guidelines in Intensive Care Development and Evaluation (GUIDE) Group, He Research Institute St. Joseph’s Healthcare Hamilton, Department of Health Research Methods, Evidence, and Impact, McMaster University |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/34677620$$D View this record in MEDLINE/PubMed |
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| ISSN | 0342-4642 1432-1238 |
| IngestDate | Tue Nov 04 01:46:29 EST 2025 Fri Sep 05 14:32:48 EDT 2025 Wed Nov 05 03:11:02 EST 2025 Sat Nov 29 13:22:54 EST 2025 Sat Nov 29 11:17:13 EST 2025 Sat Nov 29 10:02:11 EST 2025 Mon Jul 21 06:03:15 EDT 2025 Sat Nov 29 05:59:46 EST 2025 Tue Nov 18 22:18:57 EST 2025 Fri Feb 21 02:47:06 EST 2025 |
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| Issue | 12 |
| Keywords | Plasma Intensive care Transfusion Red blood cells Critically ill Point of care Tranexamic acid Guideline Platelets Coagulopathy Bleeding |
| Language | English |
| License | 2021. The Author(s). Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/. |
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| OpenAccessLink | https://link.springer.com/10.1007/s00134-021-06531-x |
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| PublicationPlace | Berlin/Heidelberg |
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| PublicationTitle | Intensive care medicine |
| PublicationTitleAbbrev | Intensive Care Med |
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| PublicationYear | 2021 |
| Publisher | Springer Berlin Heidelberg Springer Springer Nature B.V |
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To develop evidence-based clinical practice recommendations regarding transfusion practices and transfusion in bleeding critically ill adults.
Methods... To develop evidence-based clinical practice recommendations regarding transfusion practices and transfusion in bleeding critically ill adults. A taskforce... Purpose To develop evidence-based clinical practice recommendations regarding transfusion practices and transfusion in bleeding critically ill adults. Methods... To develop evidence-based clinical practice recommendations regarding transfusion practices and transfusion in bleeding critically ill adults. A taskforce... PurposeTo develop evidence-based clinical practice recommendations regarding transfusion practices and transfusion in bleeding critically ill adults.MethodsA... To develop evidence-based clinical practice recommendations regarding transfusion practices and transfusion in bleeding critically ill adults.PURPOSETo develop... |
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| Title | Transfusion strategies in bleeding critically ill adults: a clinical practice guideline from the European Society of Intensive Care Medicine |
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