This article is part of the supplement: Anemia in Critical Care: Etiology, Treatment and Prevention

Review

Transfusion trigger: when to transfuse?

John C Marshall

Professor of Surgery, University of Toronto, Toronto, Ontario, Canada

author email corresponding author email

Critical Care 2004, 8(Suppl 2):S31-S33doi:10.1186/cc2846

Published:	14 June 2004

Abstract

The decision to transfuse a hospitalized patient must balance the known risks of transfusion with the need to provide adequate tissue oxygenation and the appropriate utilization of blood as a scarce resource. The minimum tolerated hemoglobin level is not well established, and considerable variation exists in intensivists' transfusion practices. Conventional transfusion triggers of 100 g/l have been challenged by reports indicating that aerobic metabolism is supported by hemoglobin levels of 50 g/l or less. Evidence from randomized trials also indicates that withholding transfusions may result in improved outcomes. Arbitrary numeric hemoglobin triggers, however, cannot supercede intervention based on individual physiologic need and clinical circumstances.