The British Society for Haematology (BSH) published guidelines on the management of anaemia and red cell transfusion in adult critically ill patients in 2013 (1), providing evidence based recommendations for the use of red cells in the management of anaemia in non-bleeding patients suffering critical illness. The recommendations reflected the results of several landmark studies which identified that there was no clear advantage of a liberal transfusion strategy in this patient population.
Anaemia is prevalent among critically ill patients and is associated with inferior outcomes, including poorer recovery following discharge from the intensive care unit. Up to one quarter of patients admitted to ICU receive blood component transfusion (2). This anaemia is multifactorial, with blood loss (including iatrogenic blood loss due to frequent sampling), and inflammation as contributory factors.
In 2020, the European Society for Intensive Care Medicine (ESICM) published up to date guidance on this topic with a similar scope to the previous BSH guidance (3). This BSH position paper will explore the recommendations in the ESICM guideline and consider the applicability for transfusion practice in the UK.
Declaration of Interests
The BSH paid the expenses incurred during the writing of this guidance. None of the authors had conflicts of interest to declare. All authors have made a declaration of interests to the BSH and Task Force Chairs which may be viewed on request.