A Study in Scarlet: Restrictive Red Blood Cell Transfusion Strategy

Anemia due to various etiologies occurs in critically ill patients requiring blood transfusion. Traditional transfusion goals guide our transfusion to achieve a hemoglobin goal of at least 10 g/dL. However, it is becoming increasingly evident that a restrictive transfusion goal of 7 g/dL may improve survival outcome, reduce infection, and reduce health care expenditure. Moreover, this strategy has been proven to be effective in a variety of patient population, including those who are critically ill, septic patients, those with a history of cardiac disease, those with gastrointestinal bleed, or those who suffered traumatic injury. This article reviews some of the evidence supporting the restrictive transfusion strategy.