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This prospective controlled randomized clinical trial strongly suggests that a restrictive transfusion strategy (target hematocrit: 24%) is as safe as a liberal transfusion strategy (target hematocrit: 30%) in patients undergoing cardiac surgery with cardiopulmonary bypass. The authors also observed that, overall, red blood cell transfusion was independently associated with an increased risk of death at 30 days. Taken together, these observations demonstrate once again that RBC transfusions should not be based only on a hemoglobin level.

– Philippe Van der Linden