Abstract:
Background: Lack of consensus on hemoglobin threshold and transfusion strategies have led to a wide
variation in transfusion practices and inappropriate use of blood. This may result in over ordering of
blood with minimal utilization or unnecessary allogenic blood transfusion. This may lead to financial
crisis due to costs for blood handling, laboratory tests and blood administration. So, saving of blood and
resources are required by rationalizing blood transfusion indications based on evidence-based hemoglobin
threshold and clinical predictive factors in resource limiting setup.
Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol was used to
conduct this study. PubMed, Google Scholar and Cochrane Library search engines were used to find
evidences that help to draw recommendations and conclusions.
Discussion: Half of clinical specialties used red blood cell transfusion with 7 g/dl threshold and the other
half used 8 g/dl to 9 g/dl. Restrictive strategy of blood transfusion is as effective as liberal transfusion
strategy in critically ill patients except in patients with cardiovascular diseases.
Conclusions: Transfusion is required at hemoglobin levels <7 g/dl. Recent guidelines and literatures have
consistently expressed the transfusion threshold between 7 and 10 g/dl with clinical indicators further
defining the need for allogenic transfusion in between
