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A growing body of evidence suggests that restrictive red blood cell transfusion strategies are safe. In this systematic review and meta-analysis of 31 randomized trials that involved 9800 patients, researchers compared benefits and harms of restrictive (triggers: hemoglobin, 7–9 g/dL; hematocrit, 24%–30%, or symptoms of anemia) versus liberal (triggers: hemoglobin, 9–13 g/dL; hematocrit, 30%–40%) red blood cell transfusion strategies.
Risks for death, overall morbidity, fatal and nonfatal myocardial infarction, stroke, and kidney failure did not differ between patients randomized to restrictive transfusion strategies and those randomized to liberal strategies. However, patients randomized to restrictive transfusion strategies had fewer infec…