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

Alexander P.J. Vlaar; 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; Marcella C.A. Müller; Marcus Lance; Nathan D. Nielsen; Herbert Schöchl; Beverley J. Hunt; Maurizio Cecconi; Simon Oczkowski

doi:https://doi.org/10.1007/s00134-021-06531-x

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

Alexander P.J. Vlaar, 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, Marcella C.A. Müller, Marcus Lance, Nathan D. Nielsen, Herbert Schöchl, Beverley J. Hunt, Maurizio Cecconi, Simon Oczkowski

Research output: Contribution to journal › Article › Academic › peer-review

42 Citations (Scopus)

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.

Original language	English
Pages (from-to)	1368-1392
Number of pages	25
Journal	Intensive care medicine
Volume	47
Issue number	12
DOIs	https://doi.org/10.1007/s00134-021-06531-x
Publication status	Published - Dec 2021

Keywords

Bleeding
Coagulopathy
Critically ill
Guideline
Intensive care
Plasma
Platelets
Point of care
Red blood cells
Tranexamic acid
Transfusion

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Vlaar, A. P. J., Dionne, J. C., de Bruin, S., Wijnberge, M., Raasveld, S. J., van Baarle, F. E. H. P., Antonelli, M., Aubron, C., Duranteau, J., Juffermans, N. P., Meier, J., Murphy, G. J., Abbasciano, R., Müller, M. C. A., Lance, M., Nielsen, N. D., Schöchl, H., Hunt, B. J., Cecconi, M., & Oczkowski, S. (2021). Transfusion strategies in bleeding critically ill adults: a clinical practice guideline from the European Society of Intensive Care Medicine: Guidelines. Intensive care medicine, 47(12), 1368-1392. https://doi.org/10.1007/s00134-021-06531-x

@article{7112cb9bcde847388adc6c37f04ae24f,

title = "Transfusion strategies in bleeding critically ill adults: a clinical practice guideline from the European Society of Intensive Care Medicine: Guidelines",

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.",

keywords = "Bleeding, Coagulopathy, Critically ill, Guideline, Intensive care, Plasma, Platelets, Point of care, Red blood cells, Tranexamic acid, Transfusion",

author = "Vlaar, {Alexander P.J.} and Dionne, {Joanna C.} and {de Bruin}, Sanne and Marije Wijnberge and Raasveld, {S. Jorinde} and {van Baarle}, {Frank E.H.P.} and Massimo Antonelli and Cecile Aubron and Jacques Duranteau and Juffermans, {Nicole P.} and Jens Meier and Murphy, {Gavin J.} and Riccardo Abbasciano and M{\"u}ller, {Marcella C.A.} and Marcus Lance and Nielsen, {Nathan D.} and Herbert Sch{\"o}chl and Hunt, {Beverley J.} and Maurizio Cecconi and Simon Oczkowski",

note = "Funding Information: The Guidelines in Intensive Care Development and Evaluation (GUIDE) group provided methodological support throughout the guideline development process. We also thank Gordon Guyatt for his mentorship. Publisher Copyright: {\textcopyright} 2021, The Author(s).",

year = "2021",

month = dec,

doi = "https://doi.org/10.1007/s00134-021-06531-x",

language = "English",

volume = "47",

pages = "1368--1392",

journal = "Intensive care medicine",

issn = "0342-4642",

publisher = "Springer Verlag",

number = "12",

}

Vlaar, APJ, Dionne, JC, de Bruin, S , Wijnberge, M, Raasveld, SJ, van Baarle, FEHP, Antonelli, M, Aubron, C, Duranteau, J, Juffermans, NP, Meier, J, Murphy, GJ, Abbasciano, R, Müller, MCA, Lance, M, Nielsen, ND, Schöchl, H, Hunt, BJ, Cecconi, M & Oczkowski, S 2021, 'Transfusion strategies in bleeding critically ill adults: a clinical practice guideline from the European Society of Intensive Care Medicine: Guidelines', Intensive care medicine, vol. 47, no. 12, pp. 1368-1392. https://doi.org/10.1007/s00134-021-06531-x

Transfusion strategies in bleeding critically ill adults: a clinical practice guideline from the European Society of Intensive Care Medicine: Guidelines. / Vlaar, Alexander P.J.; Dionne, Joanna C.; de Bruin, Sanne et al.
In: Intensive care medicine, Vol. 47, No. 12, 12.2021, p. 1368-1392.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Transfusion strategies in bleeding critically ill adults

T2 - a clinical practice guideline from the European Society of Intensive Care Medicine: Guidelines

AU - Vlaar, Alexander P.J.

AU - Dionne, Joanna C.

AU - de Bruin, Sanne

AU - Wijnberge, Marije

AU - Raasveld, S. Jorinde

AU - van Baarle, Frank E.H.P.

AU - Antonelli, Massimo

AU - Aubron, Cecile

AU - Duranteau, Jacques

AU - Juffermans, Nicole P.

AU - Meier, Jens

AU - Murphy, Gavin J.

AU - Abbasciano, Riccardo

AU - Müller, Marcella C.A.

AU - Lance, Marcus

AU - Nielsen, Nathan D.

AU - Schöchl, Herbert

AU - Hunt, Beverley J.

AU - Cecconi, Maurizio

AU - Oczkowski, Simon

N1 - Funding Information: The Guidelines in Intensive Care Development and Evaluation (GUIDE) group provided methodological support throughout the guideline development process. We also thank Gordon Guyatt for his mentorship. Publisher Copyright: © 2021, The Author(s).

PY - 2021/12

Y1 - 2021/12

N2 - 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.

AB - 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.

KW - Bleeding

KW - Coagulopathy

KW - Critically ill

KW - Guideline

KW - Intensive care

KW - Plasma

KW - Platelets

KW - Point of care

KW - Red blood cells

KW - Tranexamic acid

KW - Transfusion

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U2 - https://doi.org/10.1007/s00134-021-06531-x

DO - https://doi.org/10.1007/s00134-021-06531-x

M3 - Article

C2 - 34677620

SN - 0342-4642

VL - 47

SP - 1368

EP - 1392

JO - Intensive care medicine

JF - Intensive care medicine

IS - 12

ER -

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

Abstract

Keywords

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