Lower versus higher hemoglobin threshold for transfusion in septic shock

Lower versus higher hemoglobin threshold for transfusion in septic shock. NEJM, October 2014 [online]

Holst, L.B., et al.

http://www.nejm.org/doi/full/10.1056/NEJMoa1406617?af=R&rss=currentIssue

Blood transfusions are frequently given to patients with septic shock. However, the benefits and harms of different hemoglobin thresholds for transfusion have not been established. In this multicenter, parallel-group trial, we randomly assigned patients in the intensive care unit (ICU) who had septic shock and a hemoglobin concentration of 9 g per deciliter or less to receive 1 unit of leukoreduced red cells when the hemoglobin level was 7 g per deciliter or less (lower threshold) or when the level was 9 g per deciliter or less (higher threshold) during the ICU stay. The primary outcome measure was death by 90 days after randomization.