Aryabhatta Sadhu: Evidence-Based Restrictive Transfusion and Patient Blood Management
Aryabhatta Sadhu, Attending Consultant and Head of Transfusion Medicine at Fortis Hospital Shalimar Bagh, New Delhi, shared a post on LinkedIn:
“One of the most deeply entrenched assumptions in clinical practice is that more transfusion equates to better patient care.
The evidence does not support that conclusion.
Over the past two decades, landmark studies including TRICC, FOCUS, and TRISS, together with contemporary AABB recommendations, have consistently demonstrated that liberal transfusion strategies often fail to improve outcomes in stable patients while increasing exposure to transfusion-related complications and resource utilization.
Modern transfusion medicine extends far beyond the administration of blood components. It is a discipline centered on clinical decision-making, patient safety, and evidence-based hemotherapy.
The evolution has been clear:
- From product-focused transfusion to patient-centered care
- From empirical component use to goal-directed therapy
- From laboratory values alone to clinically meaningful outcomes
- From reactive transfusion practices to Patient Blood Management (PBM)
Every transfusion should be guided by a fundamental question:
What specific physiological deficit is being corrected, and is transfusion the most appropriate intervention to address it?
The objective is not to transfuse less.
The objective is to transfuse appropriately.”
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