Bethesda, Md. – AABB today issued a list of five recommendations that will assist in the evaluation of the need for transfusions of blood and blood components. This list, which was developed as part of the ABIM Foundation’s Choosing Wisely campaign, highlights evidence-based recommendations that promote appropriate patient blood management.
“If you look at the literature, as much as one-quarter of transfusions are probably unnecessary,” said Jeannie Callum, MD, FRCP — AABB board member and associate scientist at Sunnybrook Health Sciences Center in Toronto. “Education is needed to inform physicians that they can use less blood and blood components and have equal or better patient outcomes.”
The list of recommendations incorporates five key messages:
- Don’t transfuse more units of blood than absolutely necessary.
- Don’t transfuse red blood cells for iron deficiency without hemodynamic instability.
- Don’t routinely use blood products to reverse warfarin.
- Don’t perform serial blood counts on clinically stable patients.
- Don’t transfuse O-negative blood except to O-negative patients and in emergencies for women of child-bearing potential of unknown blood group.
The recommendations were developed through a process that involved representatives from AABB’s membership, its Board of Directors, and members of various AABB professional committees. According to AABB President Graham Sher, MD, PhD, the AABB board decided that joining the Choosing Wisely campaign was a sound opportunity to raise awareness about appropriate blood use beyond AABB’s own membership. The Choosing Wisely campaign’s goal of promoting appropriate use of tests and procedures matched with AABB’s strategic initiative focusing on patient blood management.
“Transfusions are consistently one of the most common procedures performed during hospitalizations,” said Miriam A. Markowitz, AABB chief executive officer. “It is critical that we do our best to help ensure that each blood donation is used responsibly and appropriately so that this lifesaving resource is available to patients in need and that the best possible outcomes are achieved.”
The Choosing Wisely campaign aims to promote conversations between physicians and patients that lead to informed and effective care choices that are supported by evidence, free from harm and truly necessary.