{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T10:24:35Z","timestamp":1782901475307,"version":"3.54.5"},"reference-count":47,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T00:00:00Z","timestamp":1653350400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion Medicine"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Restrictive blood transfusion is recommended by major guidelines for perioperative management, but requires objective assessment at 7\u201310\u00a0g\/dl haemoglobin (Hb). A scoring system that considers the physiological needs of the heart may simply the practice and reduce transfusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients (14\u201365\u2009years of age) undergoing non\u2010cardiac surgery were randomised at a 1:1 ratio to a control group versus a Perioperative Transfusion Trigger Score (POTTS) group. POTTS (maximum of 10) was calculated as 6 plus the following: adrenaline infusion rate (0 for no infusion, 1 for \u22640.05\u2009\u03bcg\u00b7kg<jats:sup>\u22121<\/jats:sup>\u00b7min<jats:sup>\u22121<\/jats:sup>, and 2 for higher rate), FiO<jats:sub>2<\/jats:sub> to keep SpO<jats:sub>2<\/jats:sub> at \u226595% (0 for \u226435%, 1 for 36%\u201350%, and 2 for higher), core temperature (0 for &lt;38\u00b0C, 1 for 38\u201340\u00b0C, and 2 for higher), and angina history (0 for no, 1 for exertional, and 2 for resting). Transfusion is indicated when actual Hb is lower than the calculated POTTS in individual patients. Transfusion in the control group was based on the 2012 American Association for Blood Banks (AABB) guideline. The primary outcome was the proportion of the patients requiring transfusion of allogeneic red blood cells (RBCs) during the perioperative period (until discharge from hospital), as assessed in the intention\u2010to\u2010treat (ITT) population (all randomised subjects).<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>A total of 864 patients (mean age 44.4\u2009years, 244 men and 620 women) were enrolled from December 2017 to January 2021 (433 in the control and 431 in the POTTS group). Baseline Hb was 9.2\u2009\u00b1\u20091.8 and 9.2\u2009\u00b1\u20091.7\u00a0g\/dl in the control and POTTS groups, respectively. In the ITT analysis, the proportion of the patients receiving allogeneic RBCs was 43.9% (190\/433) in the control group versus 36.9% (159\/431) in the POTTS group (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.036). Lower rate of allogeneic RBCs transfusion in the POTTS group was also evident in the per\u2010protocol analysis (42.8% vs. 35.5%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.030). Transfusion volume was 4.0 (2.0, 6.0) and 3.5 (2.0, 5.5) units (200\u2009ml\/unit) in the control and POTTS groups, respectively (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.25). The rate of severe postoperative complications (Clavien\u2010Dindo grade IIIa and higher) was 3.9% in the control group versus 1.2% in the POTTS group (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.010).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Transfusion of allogeneic RBCs based on the POTTS was safe and reduced the transfusion requirement in patients undergoing non\u2010cardiac surgery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tme.12883","type":"journal-article","created":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T03:55:01Z","timestamp":1653450901000},"page":"375-382","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["A physiology\u2010based trigger score to guide perioperative transfusion of allogeneic red blood cells: A multicentre randomised controlled trial"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6226-2602","authenticated-orcid":false,"given":"Kejian","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Anesthesiology The Third Affiliated Hospital of Guangxi Medical University  Nanning Guangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zehan","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Affiliated Hospital of Youjiang Medical University for Nationalities  Baise Guangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shucong","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology The Third Affiliated Hospital of Guangxi Medical University  Nanning Guangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengting","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Affiliated Hospital of Youjiang Medical University for Nationalities  Baise Guangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunying","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Affiliated Hospital of Youjiang Medical University for Nationalities  Baise Guangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingqing","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology The Third Affiliated Hospital of Guangxi Medical University  Nanning Guangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huijun","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology People's Hospital of Guangxi Zhuang Autonomous Region  Nanning Guangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yafeng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology People's Hospital of Guangxi Zhuang Autonomous Region  Nanning Guangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology West China Hospital, Sichuan University  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ailan","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology People's Hospital of Guangxi Zhuang Autonomous Region  Nanning Guangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0744-9727","authenticated-orcid":false,"given":"Yanjuan","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology The Third Affiliated Hospital of Guangxi Medical University  Nanning Guangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,5,24]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-157-1-201206190-00429"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200607000-00030"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.13489"},{"key":"e_1_2_9_5_1","volume-title":"Miller's Anesthesia","author":"Miller RD","year":"2015"},{"key":"e_1_2_9_6_1","unstructured":"Technical specification for clinical blood transfusion issued by the Ministry of Health of China. 2000. No. 184.http:\/\/www.nhc.gov.cn\/yzygj\/s3589\/200804\/adac19e63a4f49acafab8e0885bf07e1.shtml(Accessed November 8 2001)."},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.4103\/0366-6999.159357"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(05)80195-7"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2010.02632.x"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.7326\/M14-1589"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/imi.0000000000000180"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1382925"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-018-06624-7"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/tme.12446"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)01313-6"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0b013e32830f1fd1"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2017.05.002"},{"key":"e_1_2_9_19_1","first-page":"11","article-title":"Descriptions of acute transfusion reactions in the teaching hospitals of Kermanshah university of medical sciences, Iran","volume":"7","author":"Payandeh M","year":"2013","journal-title":"Int J Hematol"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.12373"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOH.0000000000000607"},{"key":"e_1_2_9_22_1","volume-title":"Transfusion\u2010Related Acute Lung Injury","author":"Cho MS","year":"2021"},{"key":"e_1_2_9_23_1","first-page":"30","article-title":"Blood product transfusion in adults: indications, adverse reactions, and modifications","volume":"102","author":"Raval JS","year":"2020","journal-title":"Am Fam Physician"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002948"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000001506"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1423-0410.2012.01606.x"},{"key":"e_1_2_9_27_1","first-page":"70","article-title":"A survey on transfusion status in orthopedic surgery at a trauma center","volume":"4","author":"Soleimanha M","year":"2016","journal-title":"Arch Bone Joint Surg"},{"key":"e_1_2_9_28_1","first-page":"9731095","article-title":"Blood transfusions and tumor biopsy may increase hcc recurrence rates after liver transplantation","volume":"2017","author":"Seehofer D","year":"2017","journal-title":"J Transpl"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9030689"},{"key":"e_1_2_9_30_1","first-page":"672","article-title":"Perioperative blood transfusion is one of the factors that affect the prognosis of gastric cancer","volume":"23","author":"Xu D","year":"2018","journal-title":"J Buon"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10120-014-0456-x"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2017.02.009"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001990"},{"key":"e_1_2_9_34_1","first-page":"481","article-title":"Perioperative blood management: from restrictive transfusion to individualized transfusion","volume":"94","author":"Liao R","year":"2014","journal-title":"Chin Med J (Engl)"},{"key":"e_1_2_9_35_1","volume-title":"Annual of Report on the Development of China's Anesthesiology","author":"Yuguang H","year":"2019"},{"key":"e_1_2_9_36_1","unstructured":"National Health Commission of the People's Republic of China.Statistical Bulletin of China's Health Development in 2018.2019.http:\/\/www.nhc.gov.cn\/guihuaxxs\/s10748\/201905\/9b8d52727cf346049de8acce25ffcbd0.shtml."},{"key":"e_1_2_9_37_1","unstructured":"National Health Commission of the People's Republic of China.Statistical bulletin of China's health development in 2019.2020.http:\/\/www.nhc.gov.cn\/guihuaxxs\/s10748\/202006\/ebfe31f24cc145b198dd730603ec4442.shtml."},{"key":"e_1_2_9_38_1","volume-title":"Statistical Bulletin of China's Health Development in 2020","year":"2021"},{"issue":"1","key":"e_1_2_9_39_1","first-page":"23","article-title":"Recommendations for the implementation of a patient blood management programme. Application to elective major orthopaedic surgery in adults","volume":"14","author":"Vaglio S","year":"2016","journal-title":"Blood Transfus"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.12946"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/tme.12754"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e318254d1a3"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aes139"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/tme.12780"},{"key":"e_1_2_9_45_1","unstructured":"Best Pract Res Clin Anaesthesiol 2014 28"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.24015\/JAPM.2015.0017"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12288-019-01180-z"},{"key":"e_1_2_9_48_1","first-page":"8262","article-title":"Clavien\u2010dindo classification and risk factors of gastrectomy\u2010related complications: an analysis of 1049 patients","volume":"8","author":"Xiao H","year":"2015","journal-title":"Int J Clin Exp Med"}],"updated-by":[{"DOI":"10.1111\/tme.12951","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T00:00:00Z","timestamp":1677110400000}}],"container-title":["Transfusion Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tme.12883","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tme.12883","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tme.12883","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T16:13:00Z","timestamp":1692634380000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tme.12883"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,24]]},"references-count":47,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,10]]}},"alternative-id":["10.1111\/tme.12883"],"URL":"https:\/\/doi.org\/10.1111\/tme.12883","archive":["Portico"],"relation":{"correction":[{"id-type":"doi","id":"10.1111\/tme.12951","asserted-by":"object"}]},"ISSN":["0958-7578","1365-3148"],"issn-type":[{"value":"0958-7578","type":"print"},{"value":"1365-3148","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,24]]},"assertion":[{"value":"2021-08-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-05-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-05-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}