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A restrictive transfusion policy in critically ill adults may be superior to a liberal strategy, but the optimal strategy in children is unknown. In a multisite clinical trial, researchers randomly assigned 637 stable critically ill children (age range, 3 days–14 years) with hemoglobin (Hb) concentrations of 9.5 g/dL or lower to either a restrictive transfusion protocol (Hb threshold, 7 g/dL with a target of 8.5–9.5 g/dL) or a liberal transfusion protocol (Hb threshold, 9.5 g/dL with a target of 11–12 g/dL) for up to 28 days in the ICU or until death.
During the study, the average difference in Hb levels between the two groups was 2.1 g/dL. No differences between groups were observed in primary outcomes, including death or multiple organ dys…