Numerous trials have demonstrated the benefit of lower hemoglobin thresholds for blood transfusion in critically ill patients.
The recently published Transfusion Requirements in Septic Shock (TRISS) trial evaluated the effects on mortality of a lower versus higher hemoglobin threshold in ICU patients with septic shock.
The TRISS trial randomized 1005 patients to a lower hemglobin threshold (7 g/dL) or a higher hemoglobin threshold (9 g/dL).
Overall, there was no difference in 90-day mortality between groups.
Patients randomized to the lower threshold received significantly fewer units without any increase in ischemic or adverse events.
Take Home Point: A hemoglogin threshold of 7 g/dL for blood transfusion appears effective for most patients with septic shock.
References
Holst LB, et al. Lower versus higher hemoglobin threshold for transfusion in septic shock. NEJM 2014; [published online]
