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In this retrospective study of 421 patients with subarachnoid hemorrhage (SAH) in the intensive care unit, the relationship between red blood cell transfusion (RBCT) and extracerebral complications and infection was examined. RBCT was independently associated with medical complications (OR 1.8 [1.1-3]; p=0.02), infections (OR 2.8 [1.7-4.5]; p<0.001), the need for and duration of mechanical ventilation (OR 2.8 [1.5-5.1]; p<0.001) and length of stay (p<0.001). However, whether RBCT is a cause of medical complications or simply a marker of disease severity requires further study. – Charlotte Quentin and Jean-Franois Hardy