Appropriateness of red blood cell transfusions in major urban hospitals and effectiveness of an intervention.

The article describes a too liberal indication for RBC transfusions if recent knowledge on the critical threshold of hemoglobin (Hbert et al.) is applied. However, one should not forget that this is not yet a generally accepted threshold under routine conditions. Although the data provided by Hbert et al. are convincing, it takes time to make it school of thought and to change a long-standing practice. Besides, this article also shows the interesting fact that all interventions of the quality management system are rather ineffective to influence transfusion practice. Therefore, it is necessary to better educate and train physicians (as early as possible).

– V. Kretschmer.