Transfusion Thresholds in Critically Ill Patients

Abstract This chapter explores the TRICC trial, which compares restrictive and liberal transfusion strategies in critically ill patients. The trial investigated whether a restrictive approach (transfuse for hemoglobin < 7 g/dL) is equivalent to a liberal strategy (transfuse for hemoglobin < 10 g/dL) in terms of patient outcomes. The trial enrolled 838 patients from 22 tertiary and three community intensive care units, focusing on mortality and organ dysfunction. No significant difference was shown in 30-day mortality between the two groups, but the restrictive strategy resulted in fewer transfusions and a lower incidence of cardiac events. Finally, the chapter emphasizes that while restrictive transfusion thresholds benefit most critically ill patients, clinical judgment should guide their application, particularly in patients with active cardiac conditions.