A recent study published in JAMA adds support for the growing body of evidence recommending a restrictive red blood cell (RBC) transfusion strategy.
Rohde et al. performed a meta-analysis comparing hospital-acquired infections from 7,500 patients enrolled in 18 randomized trials. They found rates of hospital-acquired infections were 16.9% in the liberal transfusion group and 11.8% in the conservative transfusion group (risk ratio = 0.82; 95% CI, 0.72-0.95). When the restrictive transfusion threshold was set at less than 7.0 g/dL, the number needed to treat was 20, indicating that one patient could potentially avoid an infection out of every 20 patients treated. The reduced risk of infection remained even among individuals who received leukocyte reduced RBCs. More studies are needed to determine the optimal threshold for restrictive RBC transfusion strategies.
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