Table 1 Large prospective randomized clinical trials on transfusion triggers
Clinical trial | Patient population | Restrictive strategy (Hb trigger – target) (g/dl) | Liberal strategy (Hb trigger – target) (g/dl) | Reduction in blood utilization | Primary outcome | |||
|---|---|---|---|---|---|---|---|---|
| Â | Â | Â | Â | Â | Event | Restrictive strategy incidence (%) | Liberal strategy incidence (%) | P value |
Hébert and colleagues [3] (n = 838) | Critically ill (adults) | 7 to 8.5 | 10 to 10.7 | 54% less RBC units transfused | 30-day mortality | 18.7 | 23.3% | 0.11 |
Hajjar and colleagues [5] (n = 502) | Cardiac surgery (adults) | 8 to 9.1 | 10 to 10.5 | 58% less RBC units transfused | Composite endpoint | 11 | 105 | 0.85 |
|  |  |  |  |  | • 30-day mortality | 6 | 6 | 0.93 |
|  |  |  |  |  | • Cardiogenic shock | 9 | 1 | 0.42 |
|  |  |  |  |  | • ARDS | 2 | 5 | 0.99 |
|  |  |  |  |  | • Acute renal injury requiring dialysis | 4 |  | 0.99 |
Carson and colleagues [7] (n = 2,016) | Femur fracture (older adults) | 8.0 to 9.5 | 10.0 to 11.0 | 65% less RBC units transfused | Composite endpoint | 34.7 | 35.2 | NS |
|  |  |  |  |  | • 60-day mortality | 28.1 | 27.6 | NS |
|  |  |  |  |  | • 60-day inability to walk | 6.6 | 7.6 | NS |
Villanueva and colleagues [9] (n = 921) | Gastrointestinal bleeding (adults) | 7 to 9.2 | 9 to 10.1 | 59% less RBC units transfused | 45-day all-cause mortality | 5 | 9 | 0.02 |
Holst and colleagues (n = 998) [8] | Sepsis in the ICU (adults) | <7.0 | 7.0 to 9.0 | 50% less RBC units transfused | 90-day all-cause mortality | 43 | 45 | 0.44 |