Reducing by half the typical amount of blood provided through transfusions to burn patients makes no difference in terms of patient outcomes, a new multi–center study led by UC Davis researchers shows.

Blood transfusions help maintain oxygen levels, reduce anemia, support tissue healing and preserve organ function in burn patients. How much blood to use has been controversial, especially because of transfusion–related risks such as infection, lung injury, fluid overload and clotting disorders.

The study – presented at the American Surgical Association meeting – is the first to define evidence–based best practices when using blood transfusions to treat burn patients.

"The general thinking among burn specialists has been that more is better when it comes to blood transfusions,” said Tina Palmieri, director of the Firefighters Burn Institute Regional Burn Center at UC Davis Medical Center and assistant chief of burn surgery for Shriners Hospitals for Children – Northern California. “We wanted to see if a more restrictive strategy, similar to what is used in other critical–care specialties, made sense for burn patients as well.”

In conducting the study, lead author Palmieri and researchers at 18 burn centers in the U.S., Canada and New Zealand enrolled a total of 345 patients with burns over 20 percent of their bodies. The patients were divided into two groups, with half receiving less blood (a median of eight units) than the other half (a median of 16 units) throughout their hospitalizations, including surgeries.

They found that that bloodstream infections, ventilator days, wound healing, organ problems and mortality were all similar between the two groups, indicating that the restrictive transfusion strategy made better use of blood resources without affecting health outcomes.

Palmieri said the study should help identify standards of care at burn centers worldwide.

"We want to do everything we can to speed the recovery of our patients, but we also don’t want to expose them to treatments they may not need and that may actually cause them harm,” Palmieri said. “Our study provides a great start to defining the most effective and appropriate use of blood transfusions for burn patients.”