Cochrane · systematic review · CD002042
Transfusion thresholds for guiding red blood cell transfusion
Carson, JL, Stanworth, SJ, Dennis, JA, et al. · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
8
current version
GRADE rated
8
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 1 · 12.5%Moderate 2 · 25%High 5 · 62.5%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyLiberal compared with restrictive transfusion protocols for guiding red blood cell transfusion
Population: adults and children (haemodynamically stable) with potential need for RBC transfusion
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Participants exposed to blood transfusion (all studies) Liberal vs restrictive transfusion protocols | RR 0.59 [0.53, 0.66] | 42 studies · 20057 participants | High |
30‐Day mortality Liberal vs restrictive transfusion protocols | RR 0.99 [0.86, 1.15] | 31 studies · 16729 participants | High |
Myocardial infarction Liberal vs restrictive transfusion protocols | RR 1.04 [0.87, 1.24] | 23 studies · 14370 participants | High |
Congestive heart failure Liberal vs restrictive transfusion protocols | RR 0.83 [0.53, 1.29] | 16 studies · 7247 participants | Low Downgraded: imprecision, inconsistency |
Cerebrovascular accident ‐ stroke Liberal vs restrictive transfusion protocols | RR 0.84 [0.64, 1.09] | 19 studies · 13985 participants | High |
Rebleeding Liberal vs restrictive transfusion protocols | RR 0.8 [0.59, 1.09] | 8 studies · 3412 participants | Moderate Downgraded: imprecision, inconsistency |
Thromboembolism Liberal vs restrictive transfusion protocols | OR 1.11 [0.65, 1.88] | 13 studies · 4201 participants | Moderate Downgraded: imprecision, inconsistency |
Infection Liberal vs restrictive transfusion protocols | RR 0.97 [0.88, 1.07] | 25 studies · 17104 participants | High |
Comparison
Population: Adults and children (haemodynamically stable) with potential need for RBC transfusion
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
People receiving blood transfusions | RR 0.57 [0.49, 0.65] | 31 studies · 12587 participants | High |
30‐day mortality | RR 0.97 [0.81, 1.16] | 23 studies · 10537 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Myocardial infarction | RR 1.08 [0.74, 1.6] | 16 studies · 8303 participants | High |
Congestive heart failure | RR 0.78 [0.45, 1.35] | 12 studies · 6257 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Cerebrovascular accident (CVA) ‐ stroke | RR 0.78 [0.53, 1.14] | 13 studies · 7343 participants | High |
Rebleeding | RR 0.75 [0.51, 1.1] | 6 studies · 3108 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Pneumonia | RR 0.94 [0.8, 1.11] | 14 studies · 6277 participants | High |
Thromboembolism | RR 0.77 [0.41, 1.45] | 10 studies · 4019 participants | High |