NAC Meeting, Québec

April 30-May 1, 2014

Canadian national guidelines for RBC and plasma transfusion were last published in 1997

These were the product of an intensive (and expensive) consensus conference

April 2011-August 2012

◦ Back and forth between NAC and P/T CBS BLC in terms of what was required / desired

◦ Ultimately decided to try look at existing guidelines (rather than revising the existing 1997 guideline)

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Association of Anaesthetists of Great Britain and Ireland (2008)

Australian Red Cross Blood Service (2010)

Guidelines and Audit Implementation Network (Northern Ireland) (2009)

American Red Cross (2007)

American Society of Anesthesiologists Task Force on Perioperative Blood Transfusion and Adjuvant Therapies (2006)

United Kingdom Blood Services (2007)

National Comprehensive Cancer Care Network (2011)

Cochrane Collaboration (2 reviews, 2010)

Italian Society of Transfusion Medicine and Immunohematology (3 guidelines, 2009 and 2011)

American College of Critical Care Medicine (2009)

Klein et al (2007)

Wang and Klein (2010)

AABB (2012)

Association of Anaesthetists of Great Britain and Ireland (2008)

Australian Red Cross Blood Service (2010)

Guidelines and Audit Implementation Network (Northern Ireland) (2009)

American Red Cross (2007)

American Society of Anesthesiologists Task Force on Perioperative Blood Transfusion and Adjuvant Therapies (2006)

United Kingdom Blood Services (2007)

National Comprehensive Cancer Care Network (2011)

Cochrane Collaboration (2 reviews, 2010)

Italian Society of Transfusion Medicine and Immunohematology (3 guidelines, 2009 and 2011)

American College of Critical Care Medicine (2009)

Klein et al (2007)

Wang and Klein (2010)

AABB (2012)

NAC RBC WG recommends: ◦ NAC endorse the AABB RBC guidelines

most reflective of current practice in Canada likely most palatable to a Canadian physician includes recommendations for pediatrics

NAC RBC WG also recommends: ◦ NAC support the creation of a companion document to:

Emphasize salient points from the AABB guidelines Emphasize not relying solely on transfusion triggers Highlight recent advances in the literature

Acute coronary syndromes GI bleed paper

Incorporate additional tools (implementation, audit)

NAC RBC WG recommends: ◦ NAC endorse the AABB RBC guidelines

most reflective of current practice in Canada likely most palatable to a Canadian physician includes recommendations for pediatrics

NAC RBC WG also recommends: ◦ NAC support the creation of a companion document to:

Emphasize salient points from the AABB guidelines Emphasize not relying solely on transfusion triggers Highlight recent advances in the literature

Acute coronary syndromes GI bleed paper

Incorporate additional tools (implementation, audit)

NAC RBC WG recommends: ◦ NAC endorse the AABB RBC guidelines

most reflective of current practice in Canada likely most palatable to a Canadian physician includes recommendations for pediatrics

NAC RBC WG also recommends: ◦ NAC support the creation of a companion document to:

Emphasize salient points from the AABB guidelines Emphasize not relying solely on transfusion triggers Highlight recent advances in the literature

Acute coronary syndromes GI bleed paper

Incorporate additional tools (implementation, audit)

www.rmcdocs.com