• Crit Care · Jan 2004

    Review

    Transfusion trigger: when to transfuse?

    • John C Marshall.
    • University of Toronto, Toronto, Ontario, Canada. john.marshall@uhn.on.ca
    • Crit Care. 2004 Jan 1; 8 Suppl 2: S31-3.

    AbstractThe 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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