"2023 AABB International Guidelines for Red Blood Cell Transfusion: Insights from JAMA"
The AABB has published updated guidelines on red blood cell (RBC) transfusion, recommending a restrictive transfusion strategy for hemodynamically stable adult patients with a hemoglobin concentration less than 7 g/dL, and for critically ill children with a hemoglobin concentration less than 7 g/dL. The guidelines suggest considering transfusion thresholds of 7.5 g/dL for patients undergoing cardiac surgery and 8 g/dL for those undergoing orthopedic surgery or with preexisting cardiovascular disease. The recommendations are based on evidence from randomized controlled trials, which showed that restrictive transfusion thresholds did not adversely affect patient-important outcomes in most patient populations. It is important for clinicians to consider the overall clinical context and alternative therapies when making transfusion decisions for individual patients.