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Updated: Jul 21, 2026
07:57
Integrated Compensatory Responses in a Human Model of Hemorrhage
Published on: November 20, 2016
Transfusion vs. alternative treatment modalities in acute bleeding: a systematic review
H E Heier1, W Bugge, K Hjelmeland
1Department of Immunology and Transfusion Medicine, Ullevaal University Hospital, University of Oslo, Oslo, Norway. h.e.heier@medisin.uio.no
Acta Anaesthesiologica Scandinavica
|August 23, 2006
Summary
Transfusion practices for acute bleeding lack strong evidence, with volume replacement and red blood cell transfusion policies often based on tradition. Antifibrinolytic drugs may reduce transfusion needs.
Area of Science:
- Critical Care Medicine
- Hematology
- Evidence-Based Medicine
Background:
- Transfusion practices vary significantly globally.
- Evidence supporting current transfusion protocols and alternatives in acute bleeding is limited.
Purpose of the Study:
- To systematically review the evidence base for transfusion practices and alternative treatments in acute bleeding.
Main Methods:
- A systematic literature review was conducted.
- 79 abstracts were selected from 2438 initial reviews after stepwise evaluation.
Main Results:
- Albumin is not superior to colloids or crystalloids for volume therapy; hypertonic solutions and resuscitation strategies remain debated.
- Hemoglobin levels above 8-9 g/dL show no mortality or morbidity benefit.
- No effective alternatives to erythrocyte transfusion were found, and evidence for platelet and plasma transfusion is scarce.
- Antifibrinolytic drugs may decrease transfusion requirements.
Conclusions:
- Transfusion policies are often based on tradition rather than robust evidence.
- Difficulties in conducting trials for acute bleeding necessitate seeking alternative scientific evidence to define best practices.
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