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A hemoglobin concentration below 10 g/dL has often triggered transfusion for critically ill patients. Concern about transfusion risks, however, has led researchers to more carefully evaluate the benefits of transfusion. This past year, Canadian researchers completed a rigorous study comparing two transfusion thresholds for intensive care patients (N Engl J Med Feb 11; 340:409).
The multicenter trial randomly assigned 838 euvolemic adults with a hemoglobin concentration of 9 g/dL or lower, but without active blood loss or chronic anemia, to transfusion when the hemoglobin concentration was either 7 g/dL or lower (restrictive strategy) or 10 g/dL or lower (liberal strategy). The transfusion goals were 7 to 9 g/dL with the restrictive strategy …