UMEM Educational Pearls

Category: Critical Care

Title: Critical illness and hemoglobin concentration

Keywords: hemoglobin, anemia, transfusions, hemorrhage, conservative, liberal, hemorrhaging (PubMed Search)

Posted: 2/1/2011 by Haney Mallemat, MD
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The optimal hemoglobin concentration during critical illness is unknown. Although a liberal transfusion strategy (Hb 10-12 g/dL) was once believed to be beneficial for hemodynamics, evidence suggests targeting a conservative strategy (Hb 7-9 g/dL) does not increase mortality, while the unnecessary transfusion of blood products can cause harm (transfusion associated lung injury, infection, etc.) in the non-hemorrhaging patient. 


1. Harder, L. Et al. The Optimal Hematocrit. Critical Care Clinics (2010) vol. 26 (2) pp. 335-354

2. Hebert P, Wells G, Blajchman M, et al. A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. N Engl J Med 1999; 340(6):409–17