• Intensive care medicine · Dec 2021

    Practice Guideline

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

    • VlaarAlexander P JAPJ0000-0002-3453-7186Department of Intensive Care Medicine, Amsterdam UMC, Location AMC, Room, C3-430, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. a.p.vlaar@amsterdamumc.nl., Joanna C Dionne, Sanne de Bruin, Marije Wijnberge, S Jorinde Raasveld, Frank E H P van Baarle, Massimo Antonelli, Cecile Aubron, Jacques Duranteau, Nicole P Juffermans, Jens Meier, Gavin J Murphy, Riccardo Abbasciano, MüllerMarcella C AMCADepartment of Intensive Care Medicine, Amsterdam UMC, Location AMC, Room, C3-430, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands., Marcus Lance, Nathan D Nielsen, Herbert Schöchl, Beverley J Hunt, Maurizio Cecconi, and Simon Oczkowski.
    • Department of Intensive Care Medicine, Amsterdam UMC, Location AMC, Room, C3-430, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. a.p.vlaar@amsterdamumc.nl.
    • Intensive Care Med. 2021 Dec 1; 47 (12): 136813921368-1392.

    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.© 2021. The Author(s).

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