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1: Crit Care. 2004;8 Suppl 2:S31-3. Epub 2004 Jun 14.
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Transfusion trigger: when to transfuse?

Marshall JC.

University of Toronto, Toronto, Ontario, Canada. john.marshall@uhn.on.ca

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.

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PMID: 15196320 [PubMed - indexed for MEDLINE]