Liberal Versus Restrictive Hemoglobin Levels As Thresholds For Blood Transfusions

Blood transfusion is a common treatment of anemia due to chronic disease or acute blood loss. However, there continues to be uncertainty concerning the appropriate threshold for transfusion. A restrictive protocol could decrease blood administered, transmissible infections, transfusion reactions, volume overload, and utilization of a limited commodity. However, anemia may result in decreased oxygen delivery which could lead to metabolic dysfunction an increased cell death. Determining an appropriate transfusion threshold is thus an important objective. A previous Cochrane review found the use of restrictive thresholds decreased transfusions compared to liberal thresholds. No difference in secondary outcomes, including 30-day mortality, hospital length of stay, cardiac events, and myocardial infarction, was noted.