Blood Transfusions in the Intensive Care Unit

Q What are the current recommendations for blood transfusions in the intensive care unit?

A Carol A. Rauen, RN, MS, CCNS, CCRN, PCCN, replies:

This excellent question is simple and specific. It is also a very important question that critical care clinicians face daily. I wish I could offer a simple and specific answer. The first documented human-to-human blood transfusion took place in 1818¹ and today packed red blood cell (PRBC) infusions are a cornerstone therapy in modern critical care practice.² The procedure known as bloodletting has a much longer history in medical practice: 2500 years. Ironically, thought to be the major treatment for “all that ails you,” bloodletting was actually proven to be detrimental to health. We can only hope that our current practice of blood administration does more good than harm.

In the absence of a simple answer to this simple question, let me share what...