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Hemoglobin Threshold in Septic Shock
- Numerous trials have demonstrated the benefit of lower hemoglobin thresholds for blood transfusion in critically ill patients.
- The recently published Transfusion Requirements in Septic Shock (TRISS) trial evaluated the effects on mortality of a lower versus higher hemoglobin threshold in ICU patients with septic shock.
- The TRISS trial randomized 1005 patients to a lower hemglobin threshold (7 g/dL) or a higher hemoglobin threshold (9 g/dL).
- Overall, there was no difference in 90-day mortality between groups.
- Patients randomized to the lower threshold received significantly fewer units without any increase in ischemic or adverse events.
- Take Home Point: A hemoglogin threshold of 7 g/dL for blood transfusion appears effective for most patients with septic shock.
References
Holst LB, et al. Lower versus higher hemoglobin threshold for transfusion in septic shock. NEJM 2014; [published online]