Korean clinical practice guideline for perioperative red blood cell transfusion from Korean society of anesthesiologists

Bon Nyeo Koo, Min A. Kwon, Sang Hyun Kim, Jong Yeop Kim, Young Jin Moon, Sun Young Park, Eun Ho Lee, Min Suk Chae, Sung Uk Choi, Jeong Hyun Choi, Jin Young Hwang

    Research output: Contribution to journalReview articlepeer-review

    17 Citations (Scopus)


    Background: Considering the functional role of red blood cells (RBC) in maintaining oxygen supply to tissues, RBC transfusion can be a life-saving intervention in situations of severe bleeding or anemia. RBC transfusion is often inevitable to address intraoperative massive bleeding; it is a key component in safe perioperative patient management. Unlike general medical resources, packed RBCs (pRBCs) have limited availability because their supply relies entirely on voluntary donations. Additionally, excessive utilization of pRBCs may aggravate prognosis or increase the risk of developing infectious diseases. Appropriate perioperative RBC transfusion is, therefore, crucial for the management of patient safety and medical resource conservation. These concerns motivated us to develop the present clinical practice guideline for evidence-based efficient and safe perioperative RBC transfusion management considering the current clinical landscape. Methods: This guideline was obtained after the revision and refinement of exemplary clinical practice guidelines developed in advanced countries. This was followed by rigorous evidence-based reassessment considering the healthcare environment of the country. Results: This guideline covers all important aspects of perioperative RBC transfusion, such as preoperative anemia management, appropriate RBC storage period, and leukoreduction (removal of white blood cells using filters), reversal of perioperative bleeding tendency, strategies for perioperative RBC transfusion, appropriate blood management protocols, efforts to reduce blood transfusion requirements, and patient monitoring during a perioperative transfusion. Conclusions: This guideline will aid decisions related to RBC transfusion in healthcare settings and minimize patient risk associated with unnecessary pRBC transfusion.

    Original languageEnglish
    Pages (from-to)91-118
    Number of pages28
    JournalKorean journal of anesthesiology
    Issue number2
    Publication statusPublished - 2019 Apr

    Bibliographical note

    Publisher Copyright:
    © The Korean Society of Anesthesiologists.


    • Blood transfusion
    • Clinical practice guideline
    • Perioperative management
    • Red blood cells

    ASJC Scopus subject areas

    • Anesthesiology and Pain Medicine


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