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Literature Summary

Major Literature

  1. Hebert. A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. N Engl J Med 1999;340:409-17
    • In a randomized controlled trial comparing a red cell transfusion trigger of 7 g/dL versus 10 g/dl in 838 critically ill resuscitated patient, there was no difference in either total 30 day mortality (18.7% vs 23.3%, P=0.11, respectively) or mortality in those with clinically significant cardiac disease (20.5% vs 22.9%; P=0.69). The restrictive transfusion policy was superior for mortality outcome in patients with APACHE II scores of <20 (8.7% vs 16.1%;P=0.03), in patients < 55 years of age (5.7% vs 13.0%; P=0.02), and during hospitalization (22.2% vs 28.1%;P=0.05).
  2. J. Lacroix, P.C. Hébert, J.H. Hutchison, et al.: Transfusion strategies for patients in pediatric intensive care units. N Engl J Med. 356:1609-1619 2007
    • In stable, critically ill children a hemoglobin threshold of 7 g per deciliter for red-cell transfusion can decrease transfusion requirements without increasing adverse outcomes. 
  3. J. Cholette, J. Rubenstein, K. Powers: Cyanotic children undergoing open heart surgery do not appear to benefit from higher hemoglobin levels: Results of a restrictive v liberal RBC transfusion strategy. Crit Care Med. 37:A434 2009
    • Children with single-ventricle physiology do not benefit from a liberal transfusion strategy after cavopulmonary connection. A restrictive red blood cell transfusion strategy decreases the number of transfusions, donor exposures, and potential risks in these children.