Practice guidelines for blood component therapy: A report by the American Society of Anesthesiologists Task Force on Blood Component Therapy

Linda C. Stehling, Dennis C. Doherty, Ronald J. Faust, A. Gerson Greenburg, Chantal R. Harrison, Dennis F. Landers, Russell K. Laros, Ellison C. Pierce, Randall S. Prust, Andrew D. Rosenberg, Richard B. Weiskopf, Steven H. Woolf, John F. Zeiger

Research output: Contribution to journalArticle

818 Citations (Scopus)

Abstract

In 1994, the American Society of Anesthesiologists established the Task Force on Blood Component Therapy to develop evidence-based indications for transfusing red blood cells, platelets, fresh-frozen plasma, and cryoprecipitate in perioperative and peripartum settings. The guidelines were developed according to an explicit methodology. The principal conclusions of the task force are that red blood cell transfusions should not be dictated by a single hemoglobin 'trigger' but instead should be based on the patient's risks of developing complications of inadequate oxygenation. Red blood cell transfusion is rarely indicated when the hemoglobin concentration is greater than 10 g/dL and is almost always indicated when it is less than 6 g/dL. The indications for autologous transfusion may be more liberal than for allogeneic (homologous) transfusion. The risks of bleeding in surgical and obstetric patients are determined by the extent and type of surgery, the ability to control bleeding, the actual and anticipatedrate of bleeding, and the consequences of uncontrolled bleeding. Prophylactic platelet transfusion is ineffective when thrombocytopenia is due to increased platelet destruction. Surgical and obstetric patients with microvascular bleeding usually require platelet transfusion if the platelet count is less than 50 x 109/l and rarely require therapy if it is greater than 100 x 109/l. Fresh- frozen plasma is indicated for urgent reversal of warfarin therapy, correction of known coagulation factor deficiencies for which specific concentrates are unavailable, and correction of microvascular bleeding when prothrombin and partial thromboplastin times are > 1.5 times normal. It is contraindicated for augmentation of plasma volume or albumin concentration. Cryoprecipitate should be considered for patients with yon Willebrand's disease unresponsive to desmopressin, bleeding patients with von Willebrand's disease, and bleeding patients with fibrinogen levels below 80-100 mg/dL. The task force recommends careful adherence to proper indications for blood component therapy to reduce the risks of transfusion.

Original languageEnglish (US)
Pages (from-to)732-747
Number of pages16
JournalAnesthesiology
Volume84
Issue number3
DOIs
StatePublished - Mar 1996
Externally publishedYes

Fingerprint

Advisory Committees
Practice Guidelines
Hemorrhage
Erythrocyte Transfusion
Platelet Transfusion
Therapeutics
Obstetrics
Hemoglobins
Blood Platelets
Peripartum Period
von Willebrand Diseases
Deamino Arginine Vasopressin
Blood Coagulation Factors
Partial Thromboplastin Time
Plasma Volume
Prothrombin
Warfarin
Platelet Count
Serum Albumin
Thrombocytopenia

Keywords

  • anemia
  • blood component therapy
  • coagulopathy
  • cryoprecipitate
  • fresh-frozen plasma
  • Practice guidelines
  • red blood cells
  • transfusion

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Stehling, L. C., Doherty, D. C., Faust, R. J., Greenburg, A. G., Harrison, C. R., Landers, D. F., ... Zeiger, J. F. (1996). Practice guidelines for blood component therapy: A report by the American Society of Anesthesiologists Task Force on Blood Component Therapy. Anesthesiology, 84(3), 732-747. https://doi.org/10.1097/00000542-199603000-00032

Practice guidelines for blood component therapy : A report by the American Society of Anesthesiologists Task Force on Blood Component Therapy. / Stehling, Linda C.; Doherty, Dennis C.; Faust, Ronald J.; Greenburg, A. Gerson; Harrison, Chantal R.; Landers, Dennis F.; Laros, Russell K.; Pierce, Ellison C.; Prust, Randall S.; Rosenberg, Andrew D.; Weiskopf, Richard B.; Woolf, Steven H.; Zeiger, John F.

In: Anesthesiology, Vol. 84, No. 3, 03.1996, p. 732-747.

Research output: Contribution to journalArticle

Stehling, LC, Doherty, DC, Faust, RJ, Greenburg, AG, Harrison, CR, Landers, DF, Laros, RK, Pierce, EC, Prust, RS, Rosenberg, AD, Weiskopf, RB, Woolf, SH & Zeiger, JF 1996, 'Practice guidelines for blood component therapy: A report by the American Society of Anesthesiologists Task Force on Blood Component Therapy', Anesthesiology, vol. 84, no. 3, pp. 732-747. https://doi.org/10.1097/00000542-199603000-00032
Stehling, Linda C. ; Doherty, Dennis C. ; Faust, Ronald J. ; Greenburg, A. Gerson ; Harrison, Chantal R. ; Landers, Dennis F. ; Laros, Russell K. ; Pierce, Ellison C. ; Prust, Randall S. ; Rosenberg, Andrew D. ; Weiskopf, Richard B. ; Woolf, Steven H. ; Zeiger, John F. / Practice guidelines for blood component therapy : A report by the American Society of Anesthesiologists Task Force on Blood Component Therapy. In: Anesthesiology. 1996 ; Vol. 84, No. 3. pp. 732-747.
@article{aa94118f99314f9283330950da0a54b9,
title = "Practice guidelines for blood component therapy: A report by the American Society of Anesthesiologists Task Force on Blood Component Therapy",
abstract = "In 1994, the American Society of Anesthesiologists established the Task Force on Blood Component Therapy to develop evidence-based indications for transfusing red blood cells, platelets, fresh-frozen plasma, and cryoprecipitate in perioperative and peripartum settings. The guidelines were developed according to an explicit methodology. The principal conclusions of the task force are that red blood cell transfusions should not be dictated by a single hemoglobin 'trigger' but instead should be based on the patient's risks of developing complications of inadequate oxygenation. Red blood cell transfusion is rarely indicated when the hemoglobin concentration is greater than 10 g/dL and is almost always indicated when it is less than 6 g/dL. The indications for autologous transfusion may be more liberal than for allogeneic (homologous) transfusion. The risks of bleeding in surgical and obstetric patients are determined by the extent and type of surgery, the ability to control bleeding, the actual and anticipatedrate of bleeding, and the consequences of uncontrolled bleeding. Prophylactic platelet transfusion is ineffective when thrombocytopenia is due to increased platelet destruction. Surgical and obstetric patients with microvascular bleeding usually require platelet transfusion if the platelet count is less than 50 x 109/l and rarely require therapy if it is greater than 100 x 109/l. Fresh- frozen plasma is indicated for urgent reversal of warfarin therapy, correction of known coagulation factor deficiencies for which specific concentrates are unavailable, and correction of microvascular bleeding when prothrombin and partial thromboplastin times are > 1.5 times normal. It is contraindicated for augmentation of plasma volume or albumin concentration. Cryoprecipitate should be considered for patients with yon Willebrand's disease unresponsive to desmopressin, bleeding patients with von Willebrand's disease, and bleeding patients with fibrinogen levels below 80-100 mg/dL. The task force recommends careful adherence to proper indications for blood component therapy to reduce the risks of transfusion.",
keywords = "anemia, blood component therapy, coagulopathy, cryoprecipitate, fresh-frozen plasma, Practice guidelines, red blood cells, transfusion",
author = "Stehling, {Linda C.} and Doherty, {Dennis C.} and Faust, {Ronald J.} and Greenburg, {A. Gerson} and Harrison, {Chantal R.} and Landers, {Dennis F.} and Laros, {Russell K.} and Pierce, {Ellison C.} and Prust, {Randall S.} and Rosenberg, {Andrew D.} and Weiskopf, {Richard B.} and Woolf, {Steven H.} and Zeiger, {John F.}",
year = "1996",
month = "3",
doi = "10.1097/00000542-199603000-00032",
language = "English (US)",
volume = "84",
pages = "732--747",
journal = "Anesthesiology",
issn = "0003-3022",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Practice guidelines for blood component therapy

T2 - A report by the American Society of Anesthesiologists Task Force on Blood Component Therapy

AU - Stehling, Linda C.

AU - Doherty, Dennis C.

AU - Faust, Ronald J.

AU - Greenburg, A. Gerson

AU - Harrison, Chantal R.

AU - Landers, Dennis F.

AU - Laros, Russell K.

AU - Pierce, Ellison C.

AU - Prust, Randall S.

AU - Rosenberg, Andrew D.

AU - Weiskopf, Richard B.

AU - Woolf, Steven H.

AU - Zeiger, John F.

PY - 1996/3

Y1 - 1996/3

N2 - In 1994, the American Society of Anesthesiologists established the Task Force on Blood Component Therapy to develop evidence-based indications for transfusing red blood cells, platelets, fresh-frozen plasma, and cryoprecipitate in perioperative and peripartum settings. The guidelines were developed according to an explicit methodology. The principal conclusions of the task force are that red blood cell transfusions should not be dictated by a single hemoglobin 'trigger' but instead should be based on the patient's risks of developing complications of inadequate oxygenation. Red blood cell transfusion is rarely indicated when the hemoglobin concentration is greater than 10 g/dL and is almost always indicated when it is less than 6 g/dL. The indications for autologous transfusion may be more liberal than for allogeneic (homologous) transfusion. The risks of bleeding in surgical and obstetric patients are determined by the extent and type of surgery, the ability to control bleeding, the actual and anticipatedrate of bleeding, and the consequences of uncontrolled bleeding. Prophylactic platelet transfusion is ineffective when thrombocytopenia is due to increased platelet destruction. Surgical and obstetric patients with microvascular bleeding usually require platelet transfusion if the platelet count is less than 50 x 109/l and rarely require therapy if it is greater than 100 x 109/l. Fresh- frozen plasma is indicated for urgent reversal of warfarin therapy, correction of known coagulation factor deficiencies for which specific concentrates are unavailable, and correction of microvascular bleeding when prothrombin and partial thromboplastin times are > 1.5 times normal. It is contraindicated for augmentation of plasma volume or albumin concentration. Cryoprecipitate should be considered for patients with yon Willebrand's disease unresponsive to desmopressin, bleeding patients with von Willebrand's disease, and bleeding patients with fibrinogen levels below 80-100 mg/dL. The task force recommends careful adherence to proper indications for blood component therapy to reduce the risks of transfusion.

AB - In 1994, the American Society of Anesthesiologists established the Task Force on Blood Component Therapy to develop evidence-based indications for transfusing red blood cells, platelets, fresh-frozen plasma, and cryoprecipitate in perioperative and peripartum settings. The guidelines were developed according to an explicit methodology. The principal conclusions of the task force are that red blood cell transfusions should not be dictated by a single hemoglobin 'trigger' but instead should be based on the patient's risks of developing complications of inadequate oxygenation. Red blood cell transfusion is rarely indicated when the hemoglobin concentration is greater than 10 g/dL and is almost always indicated when it is less than 6 g/dL. The indications for autologous transfusion may be more liberal than for allogeneic (homologous) transfusion. The risks of bleeding in surgical and obstetric patients are determined by the extent and type of surgery, the ability to control bleeding, the actual and anticipatedrate of bleeding, and the consequences of uncontrolled bleeding. Prophylactic platelet transfusion is ineffective when thrombocytopenia is due to increased platelet destruction. Surgical and obstetric patients with microvascular bleeding usually require platelet transfusion if the platelet count is less than 50 x 109/l and rarely require therapy if it is greater than 100 x 109/l. Fresh- frozen plasma is indicated for urgent reversal of warfarin therapy, correction of known coagulation factor deficiencies for which specific concentrates are unavailable, and correction of microvascular bleeding when prothrombin and partial thromboplastin times are > 1.5 times normal. It is contraindicated for augmentation of plasma volume or albumin concentration. Cryoprecipitate should be considered for patients with yon Willebrand's disease unresponsive to desmopressin, bleeding patients with von Willebrand's disease, and bleeding patients with fibrinogen levels below 80-100 mg/dL. The task force recommends careful adherence to proper indications for blood component therapy to reduce the risks of transfusion.

KW - anemia

KW - blood component therapy

KW - coagulopathy

KW - cryoprecipitate

KW - fresh-frozen plasma

KW - Practice guidelines

KW - red blood cells

KW - transfusion

UR - http://www.scopus.com/inward/record.url?scp=0009776850&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0009776850&partnerID=8YFLogxK

U2 - 10.1097/00000542-199603000-00032

DO - 10.1097/00000542-199603000-00032

M3 - Article

C2 - 8659805

AN - SCOPUS:0009776850

VL - 84

SP - 732

EP - 747

JO - Anesthesiology

JF - Anesthesiology

SN - 0003-3022

IS - 3

ER -