Australian Red Cross Blood Service

As a joint initiative of the National Health and Medical Research Council (NHMRC), Australasian Society of Blood Transfusion (ASBT) and other relevant groups, the NHMRC/ASBT Clinical Practice Guidelines for the Use of Blood Components(1) were developed to support clinical decisions about appropriate transfusion practices and the use of blood components (red blood cells, platelets, fresh frozen plasma and cryoprecipitate).

A review of these guidelines is currently being undertaken with funding and project management provided by the National Blood Authority (NBA) on behalf of all governments.

The NBA facilitated the formulation of a Steering Committee, Expert Working Group and Clinical/Consumer Reference Groups to develop a comprehensive, evidence-based Patient Blood Management Guideline comprising six modules as follows:

Module 1 – Critical Bleeding/Massive Transfusion (released 31 March 2011)

Module 2 – Peri-operative (released 9 March 2012)

Module 3 – Medical (released 12 September 2012)

Module 4 – Intensive Care (in development)

Module 5 – Obstetric (expected to commence in 2012)

Module 6 – Paediatric / Neonates (expected to commence in 2012)

Revision of the 2001 guidelines was needed due to:(2)

• increasing evidence of transfusion-related adverse outcomes, leading to the emergence of new practices, including restrictive transfusion strategies and the increased use of alternatives to transfusion in the management of anaemia
• variable (and frequently poor) compliance with the recommendations of the 2001 guidelines, indicated by a high degree of variation in transfusion practices
• failure of the 2001 guidelines to address a range of clinical settings where blood management is commonly required, including critical bleeding and massive transfusion, chronic medical conditions, obstetrics and paediatrics.

The development of the evidence-based clinical patient blood management guidelines has involved developing a set of clinical research questions and systematically reviewing the scientific literature for evidence related to those questions, then developing and grading recommendations based on a structured assessment of the evidence.(3)

References

1. NHMRC/Australasian Society of Blood Transfusion (ASBT). Clinical Practice Guidelines on the Use of Blood Components. Australia, 2001
2. National Blood Authority. Patient Blood Management Guidelines: Module 1 – Critical Bleeding/Massive Transfusion. Australia, 2011.
3. National Health and Medical Research Council (NHMRC). A guide to the development, implementation and evaluation of clinical practice guidelines. Australia, 1999.