Hemodynamics, fluids & transfusion
Intraoperative Blood Management Strategies for Patients Undergoing Noncardiac Surgery: The Ottawa Intraoperative Transfusion Consensus
Methodological details3-round anonymous Delphi, international expert panel, 38 statements rated on 7-point Likert scale; consensus at ≥75% agreement
- 3-round anonymous Delphi
- International expert panel
- 38 statements rated on 7-point Likert scale; consensus at ≥75% agreement
Recommendations
As issued by the authors
Routine preoperative and intraoperative discussion between surgeons and anesthesiologists about intraoperative red blood cell (RBC) transfusion, and postoperative review of intraoperative transfusion events
Point-of-care hemoglobin testing devices for transfusion guidance, alongside an algorithmic transfusion protocol with a restrictive hemoglobin trigger; more research needed on restrictive triggers in the OR
Detailed preoperative consent discussion with patients of the risks and benefits of both anemia and RBC transfusion, and routine disclosure of intraoperative transfusion
Postoperative morbidity and mortality as the most relevant outcomes of intraoperative RBC transfusion; triggers of 70 and 90 g/L acceptable to evaluate restrictive and liberal strategies, respectively, in clinical trials
Original publication
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