Impact of more restrictive blood transfusion strategies on clinical outcomes: a meta-analysis and systematic review.

Salpeter SR, Buckley JS, Chatterjee S
Am J Med 2014;127:124-131 e123.
NATA Rating :
Review by : P. Van der Linden
NATA Review

This systematic review evaluated the impact of a restrictive transfusion strategy based on a hemoglobin trigger < 7 g/dL on clinical outcomes in patients with a critical illness or bleed. Pooled results of 3 trials including 2364 patients showed that adoption of this restrictive strategy was associated with reduced total mortality, rebleeding, acute coronary syndrome, and pulmonary edema. The clinical relevance of such meta-analyses remains limited by the fact that the decision to transfuse a given patient may not have been based solely on a hemoglobin value. – Philippe Van der Linden