Chochrane supports restrictive transfusions

Will Cochrane break through to the blood thirsty colleagues? The image is CC by Gaviota Paseandera.
Will Cochrane break through to the blood thirsty colleagues? The image is CC by Gaviota Paseandera.

I’ve previously written a two posts on blood transfusions from a surgeons perspective (End of the blood reign and A bloody mess) and I was therefore thrilled when I stumbled upon this [Cochrane review](https://www.ncbi.nlm.nih.gov/pubmed/27731885) that concludes:

The findings provide good evidence that transfusions with allogeneic RBCs can be avoided in most patients with haemoglobin thresholds above 7 g/dL to 8 g/dL.

They included 31 trials with a total of more than 12,000 patients and found that 30-day mortality wasn’t affected. They also didn’t find any difference regarding the incidence of complications. I was a little bummed that they didn’t find a reduced prevalence of infectious diseases with the more restrictive approach since blood is well-known to be a powerful [immune suppressor](https://www.ncbi.nlm.nih.gov/pubmed/12777903). I guess the fact that the restrictive approach reduced the transfusions by 2/5 should be enough for my colleagues to reconsider their previous beliefs.

[J. L. Carson et al., “Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion,” Cochrane Database Syst Rev, vol. 10, p. CD002042, Oct. 2016.](http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD002042.pub4/abstract;jsessionid=B28B2E04CE80F2F16BF40DDAAB811E3D.f03t01)

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