There are multiple reasons why critically ill patients become anaemic, including repeated blood sampling for laboratory testing. The decision to transfuse a patient is always patient specific and guided by clinical factors that include comorbidities and acute illness.
Research has led to the development of recommended transfusion thresholds for patients in intensive care to aid clinical decision making.
In general, a restrictive approach to blood transfusion is now favoured. The TRICC (Transfusion Requirements in Critical Care) trial has shown that the 30-day mortality rate was lower among patients transfused when their haemoglobin concentration dropped below a threshold of 70 g/l than among those with a threshold of 100 g/l.1 Furthermore, observational studies have shown that red- cell transfusions in critically ill patients increase adverse outcomes, including increased risk of infection, acute respiratory distress syndrome and worsening organ dysfunction.
It is recognised that best practice transfusion thresholds can assist clinicians with decision making, but the decision to transfuse will always be patient specific following consideration of the benefits and risks of transfusion.
