A Multicenter, Randomized, Controlled Clinical Trial of Transfusion Requirements in Critical Care
Paul C. Hébert, M.D., George Wells, Ph.D., Morris A. Blajchman, M.D., John Marshall, M.D., Claudio Martin, M.D., Giuseppe Pagliarello, M.D., Martin Tweeddale, M.D., Ph.D., Irwin Schweitzer, M.Sc., Elizabeth Yetisir, M.Sc., for The Transfusion Requirements in Critical Care Investigators for the Canadian Critical Care Trials Group
Background To determine whether a restrictive strategy of red-celltransfusion and a liberal strategy produced equivalent resultsin critically ill patients, we compared the rates of death fromall causes at 30 days and the severity of organ dysfunction.
Methods We enrolled 838 critically ill patients with euvolemiaafter initial treatment who had hemoglobin concentrations ofless than 9.0 g per deciliter within 72 hours after admissionto the intensive care unit and randomly assigned 418 patientsto a restrictive strategy of transfusion, in which red cellswere transfused if the hemoglobin concentration dropped below7.0 g per deciliter and hemoglobin concentrations were maintainedat 7.0 to 9.0 g per deciliter, and 420 patients to a liberalstrategy, in which transfusions were given when the hemoglobinconcentration fell below 10.0 g per deciliter and hemoglobinconcentrations were maintained at 10.0 to 12.0 g per deciliter.
Results Overall, 30-day mortality was similar in the two groups(18.7 percent vs. 23.3 percent, P= 0.11). However, the rateswere significantly lower with the restrictive transfusion strategyamong patients who were less acutely ill — those withan Acute Physiology and Chronic Health Evaluation II score of20 (8.7 percent in the restrictive-strategy group and 16.1 percentin the liberal-strategy group, P=0.03) — and among patientswho were less than 55 years of age (5.7 percent and 13.0 percent,respectively; P=0.02), but not among patients with clinicallysignificant cardiac disease (20.5 percent and 22.9 percent,respectively; P=0.69). The mortality rate during hospitalizationwas significantly lower in the restrictive-strategy group (22.2percent vs. 28.1 percent, P=0.05).
Conclusions A restrictive strategy of red-cell transfusion isat least as effective as and possibly superior to a liberaltransfusion strategy in critically ill patients, with the possibleexception of patients with acute myocardial infarction and unstableangina.
Source Information
From the Critical Care Program (P.C.H., G.P.) and the Clinical Epidemiology Unit (P.C.H, G.W., I.S., E.Y.), University of Ottawa, Ottawa; the Department of Pathology, McMaster University, Hamilton, Ont. (M.A.B.); the Critical Care Program, University of Toronto, Toronto (J.M.); the Critical Care Program, University of Western Ontario, London (C.M.); and the Critical Care Program, University of British Columbia, Vancouver (M.T.) — all in Canada.
Address reprint requests to Dr. Hébert at the Department of Medicine, Ottawa General Hospital, 501 Smyth Rd., Box 205, Ottawa, ON K1H 8L6, Canada.
Blood Transfusions in Critical Care
Pilla M. A., Gemma M., Beretta L., Ledger W. J., Barach P., Small S. D., Hébert P. C., The Transfusion Requirements in Critical Care Trial
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N Engl J Med 1999;
341:123-124, Jul 8, 1999.
Correspondence
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[Abstract][Full Text]
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359: 928-937
[Full Text]
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[Abstract][Full Text]
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[Abstract][Full Text]
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[Abstract][Full Text]
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(2008). Blood Banks Under Siege. Chest
134: 214-215
[Full Text]
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[Abstract][Full Text]
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28: 78-80
[Full Text]
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133: 1328-1335
[Abstract][Full Text]
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94: 661-666
[Full Text]
McDonald, V., Ryland, K.
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[Abstract]
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[Abstract][Full Text]
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[Abstract][Full Text]
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358: 1295-1296
[Full Text]
Shermock, K. M., Horn, E., Rice, T. L.
(2008). Erythropoietic agents for anemia of critical illness. Am J Health Syst Pharm
65: 540-546
[Abstract][Full Text]
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85: 836-844
[Abstract][Full Text]
Marshall, J. C.
(2008). Sepsis: rethinking the approach to clinical research. J. Leukoc. Biol.
83: 471-482
[Abstract][Full Text]
Jawa, R. S., Anillo, S., Kulaylat, M. N.
(2008). Transfusion-Related Acute Lung Injury. J Intensive Care Med
23: 109-121
[Abstract]
Tanaka, K. A., Taketomi, T., Szlam, F., Calatzis, A., Levy, J. H.
(2008). Improved Clot Formation by Combined Administration of Activated Factor VII (NovoSeven(R)) and Fibrinogen (Haemocomplettan(R) P). Anesth. Analg.
106: 732-738
[Abstract][Full Text]
Collier, B., Dossett, L. A., May, A. K., Diaz, J. J.
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23: 3-15
[Abstract][Full Text]
Weber, R. S., Jabbour, N., Martin, R. C. G. II
(2008). Anemia and Transfusions in Patients Undergoing Surgery for Cancer. Ann. Surg. Oncol.
15: 34-45
[Abstract][Full Text]
Tinmouth, A. T. MD MSc, McIntyre, L. A. MD MSc, Fowler, R. A. MDCM MS
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178: 49-57
[Abstract][Full Text]
Khalpey, Z. I., Ganim, R. B., Rawn, J. D.
(2008). Postoperative Care of Cardiac Surgery Patients. Card Surg Adult
3: 465-486
[Full Text]
de Boer, M. T., Christensen, M. C., Asmussen, M., van der Hilst, C. S., Hendriks, H. G. D., Slooff, M. J. H., Porte, R. J.
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106: 32-44
[Abstract][Full Text]
Wheeler, A. P.
(2007). Recent Developments in the Diagnosis and Management of Severe Sepsis. Chest
132: 1967-1976
[Abstract][Full Text]
Rawn, J. D.
(2007). Blood Transfusion in Cardiac Surgery: A Silent Epidemic Revisited. Circulation
116: 2523-2524
[Full Text]
Murphy, G. J., Reeves, B. C., Rogers, C. A., Rizvi, S. I.A., Culliford, L., Angelini, G. D.
(2007). Increased Mortality, Postoperative Morbidity, and Cost After Red Blood Cell Transfusion in Patients Having Cardiac Surgery. Circulation
116: 2544-2552
[Abstract][Full Text]
Mann, E. A., Pidcoke, H. F., Salinas, J., Wade, C. E., Holcomb, J. B., Wolf, S. E., Lacara, T., Domagtoy, C., Lickliter, D., Quattrocchi, K., Snipes, L., Kuszaj, J., Prasnikar, M.
(2007). Accuracy of Glucometers Should Not Be Assumed. Am J Crit Care
16: 531-532
[Full Text]
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(2007). Evolution of adverse changes in stored RBCs. Proc. Natl. Acad. Sci. USA
104: 17063-17068
[Abstract][Full Text]
Thompson, B. T., Schoenfeld, D.
(2007). Usual Care as the Control Group in Clinical Trials of Nonpharmacologic Interventions. Proc Am Thorac Soc
4: 577-582
[Abstract][Full Text]
Shorr, A. F., Corwin, H. L.
(2007). Transfusion in Critical Care: Where Do We Go From Here?. Chest
132: 1105-1106
[Full Text]
Netzer, G., Shah, C. V., Iwashyna, T. J., Lanken, P. N., Finkel, B., Fuchs, B., Guo, W., Christie, J. D.
(2007). Association of RBC Transfusion With Mortality in Patients With Acute Lung Injury. Chest
132: 1116-1123
[Abstract][Full Text]
Corwin, H. L., Gettinger, A., Fabian, T. C., May, A., Pearl, R. G., Heard, S., An, R., Bowers, P. J., Burton, P., Klausner, M. A., Corwin, M. J., the EPO Critical Care Trials Group,
(2007). Efficacy and Safety of Epoetin Alfa in Critically Ill Patients. NEJM
357: 965-976
[Abstract][Full Text]
Cook, D., Crowther, M.
(2007). Targeting Anemia with Erythropoietin during Critical Illness. NEJM
357: 1037-1039
[Full Text]
Hare, G. M. T., Mazer, C. D., Hutchison, J. S., McLaren, A. T., Liu, E., Rassouli, A., Ai, J., Shaye, R. E., Lockwood, J. A., Hawkins, C. E., Sikich, N., To, K., Baker, A. J.
(2007). Severe hemodilutional anemia increases cerebral tissue injury following acute neurotrauma. J. Appl. Physiol.
103: 1021-1029
[Abstract][Full Text]
Ohls, R. K.
(2007). Transfusions in the Preterm Infant. NeoReviews
8: e377-e386
[Abstract][Full Text]
Spence, R. K.
(2007). Medical and economic impact of anemia in hospitalized patients. Am J Health Syst Pharm
64: S3-S10
[Abstract][Full Text]
Thomas, J., Martinez, A.
(2007). Blood conservation in the critically ill. Am J Health Syst Pharm
64: S11-S18
[Abstract][Full Text]
Kleinman, S., Gajic, O., Nunes, E., on behalf of the American Association of Blood Ban,
(2007). Promoting Recognition and Prevention of Transfusion-Related Acute Lung Injury. Crit Care Nurse
27: 49-53
[Full Text]
Ridley, S., Taylor, B., Gunning, K.
(2007). Medical management of bleeding in critically ill patients. Contin Educ Anaesth Crit Care Pain
7: 116-121
[Full Text]
Gardner, T. J.
(2007). To Transfuse or Not to Transfuse. Circulation
116: 458-460
[Full Text]
Kulier, A., Levin, J., Moser, R., Rumpold-Seitlinger, G., Tudor, I. C., Snyder-Ramos, S. A., Moehnle, P., Mangano, D. T., for the Investigators of the Multicenter Study of,
(2007). Impact of Preoperative Anemia on Outcome in Patients Undergoing Coronary Artery Bypass Graft Surgery. Circulation
116: 471-479
[Abstract][Full Text]
Bratton, S. L.
(2007). Transfusions in Critically Ill Children. AAP Grand Rounds
18: 2-3
[Full Text]
Authors/Task Force Members, , Bassand, J.-P., Hamm, C. W., Ardissino, D., Boersma, E., Budaj, A., Fernandez-Aviles, F., Fox, K. A.A., Hasdai, D., Ohman, E. M., Wallentin, L., Wijns, W., ESC Committee for Practice Guidelines (CPG), , Vahanian, A., Camm, J., De Caterina, R., Dean, V., Dickstein, K., Filippatos, G., Kristensen, S. D., Widimsky, P., McGregor, K., Sechtem, U., Tendera, M., Hellemans, I., Gomez, J. L. Z., Silber, S., Funck-Brentano, C., Document Reviewers, , Kristensen, S. D., Andreotti, F., Benzer, W., Bertrand, M., Betriu, A., De Caterina, R., DeSutter, J., Falk, V., Ortiz, A. F., Gitt, A., Hasin, Y., Huber, K., Kornowski, R., Lopez-Sendon, J., Morais, J., Nordrehaug, J. E., Silber, S., Steg, P. G., Thygesen, K., Tubaro, M., Turpie, A. G.G., Verheugt, F., Windecker, S.
(2007). Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes: The Task Force for the Diagnosis and Treatment of Non-ST-Segment Elevation Acute Coronary Syndromes of the European Society of Cardiology. Eur Heart J
28: 1598-1660
[Full Text]
Farjah, F., Flum, D. R.
(2007). Hematocrit Level and Postsurgical Outcome: Powers of Observation. JAMA
297: 2525-2526
[Full Text]
Rao, S. V., Eikelboom, J. A., Granger, C. B., Harrington, R. A., Califf, R. M., Bassand, J.-P.
(2007). Bleeding and blood transfusion issues in patients with non-ST-segment elevation acute coronary syndromes. Eur Heart J
28: 1193-1204
[Abstract][Full Text]
Criner, G. J.
(2007). Framing the Forum: Medical Ethics in Large-Scale, Interventional Respiratory Clinical Trials. Proc Am Thorac Soc
4: 171-175
[Abstract][Full Text]
Silverman, H.
(2007). Ethical Issues during the Conduct of Clinical Trials. Proc Am Thorac Soc
4: 180-184
[Abstract][Full Text]
Hebert, P. C., Tinmouth, A., Corwin, H. L.
(2007). Controversies in RBC Transfusion in the Critically Ill. Chest
131: 1583-1590
[Abstract][Full Text]
Khan, H., Belsher, J., Yilmaz, M., Afessa, B., Winters, J. L., Moore, S. B., Hubmayr, R. D., Gajic, O.
(2007). Fresh-Frozen Plasma and Platelet Transfusions Are Associated With Development of Acute Lung Injury in Critically Ill Medical Patients. Chest
131: 1308-1314
[Abstract][Full Text]
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(2007). Perioperative Blood Transfusion and Blood Conservation in Cardiac Surgery: The Society of Thoracic Surgeons and The Society of Cardiovascular Anesthesiologists Clinical Practice Guideline. Ann. Thorac. Surg.
83: S27-S86
[Abstract][Full Text]
Lacroix, J., Hebert, P. C., Hutchison, J. S., Hume, H. A., Tucci, M., Ducruet, T., Gauvin, F., Collet, J.-P., Toledano, B. J., Robillard, P., Joffe, A., Biarent, D., Meert, K., Peters, M. J., the TRIPICU Investigators, the Canadian Critical C,
(2007). Transfusion Strategies for Patients in Pediatric Intensive Care Units. NEJM
356: 1609-1619
[Abstract][Full Text]
Corwin, H. L., Carson, J. L.
(2007). Blood Transfusion -- When Is More Really Less?. NEJM
356: 1667-1669
[Full Text]
Sonveaux, P., Lobysheva, I. I., Feron, O., McMahon, T. J.
(2007). Transport and Peripheral Bioactivities of Nitrogen Oxides Carried by Red Blood Cell Hemoglobin: Role in Oxygen Delivery. Physiology
22: 97-112
[Abstract][Full Text]
Memtsoudis, S. G., Rosenberger, P., Walz, J. M.
(2007). Critical Care Issues in the Patient After Major Joint Replacement. J Intensive Care Med
22: 92-104
[Abstract]
Stier, G. R., Verde, E. W.
(2007). The postoperative care of adult patients exposed to deep hypothermic circulatory arrest.. SEMIN CARDIOTHORAC VASC ANESTH
11: 77-85
[Abstract]
Salman, S. S., Fernandez Perez, E. R., Stubbs, J. R., Gajic, O.
(2007). The Practice of Platelet Transfusion in the Intensive Care Unit. J Intensive Care Med
22: 105-110
[Abstract]
Himmelfarb, J.
(2007). Continuous Renal Replacement Therapy in the Treatment of Acute Renal Failure: Critical Assessment Is Required. CJASN
2: 385-389
[Abstract][Full Text]
Nilsson, K. R., Berenholtz, S. M., Garrett-Mayer, E., Dorman, T., Klag, M. J., Pronovost, P. J.
(2007). Association Between Venous Thromboembolism and Perioperative Allogeneic Transfusion. Arch Surg
142: 126-132
[Abstract][Full Text]
DeBellis, R. J.
(2007). Anemia in critical care patients: Incidence, etiology, impact, management, and use of treatment guidelines and protocols. Am J Health Syst Pharm
64: S14-S21
[Abstract][Full Text]
Parisi, S. G., Cruciani, M., Palu, G., Moore, P. S., Chang, Y., Jaffe, H. W., Black, H. J., Johnston, A. M., Dollard, S., Pellett, P., Hladik, W., Blajchman, M. A., Vamvakas, E. C.
(2007). Transmission of Human Herpesvirus 8 by Blood Transfusion. NEJM
356: 87-89
[Full Text]
Gould, S., Cimino, M. J., Gerber, D. R.
(2007). Packed Red Blood Cell Transfusion in the Intensive Care Unit: Limitations and Consequences. Am J Crit Care
16: 39-48
[Abstract][Full Text]
Klumpp, T. R., Siegel, D. L.
(2007). Transfusion medicine. ASH-SAP
2007: 408-443
[Full Text]
McCrae, K. R., Matthews, D. C., Linenberger, M.
(2007). Consultative hematology. ASH-SAP
2007: 466-505
[Full Text]
Murphy, G. J., Angelini, G. D.
(2006). Indications for Blood Transfusion in Cardiac Surgery. Ann. Thorac. Surg.
82: 2323-2334
[Abstract][Full Text]
Otero, R. M., Nguyen, H. B., Huang, D. T., Gaieski, D. F., Goyal, M., Gunnerson, K. J., Trzeciak, S., Sherwin, R., Holthaus, C. V., Osborn, T., Rivers, E. P.
(2006). Early goal-directed therapy in severe sepsis and septic shock revisited: concepts, controversies, and contemporary findings.. Chest
130: 1579-1595
[Abstract][Full Text]
Reuben, A D, Appelboam, A V, Higginson, I, Lloyd, J G, Shapiro, N I
(2006). Early goal-directed therapy: a UK perspective.. Emerg. Med. J.
23: 828-832
[Abstract][Full Text]
Russell, J. A.
(2006). Management of Sepsis. NEJM
355: 1699-1713
[Full Text]
Walz, J. M., Paterson, C. A., Seligowski, J. M., Heard, S. O.
(2006). Surgical Site Infection Following Bowel Surgery: A Retrospective Analysis of 1446 Patients. Arch Surg
141: 1014-1018
[Abstract][Full Text]
Verma, R. R., Williamson, J. B., Dashti, H., Patel, D., Oxborrow, N. J.
(2006). Homologous blood transfusion is not required in surgery for adolescent idiopathic scoliosis.. J Bone Joint Surg Br
88-B: 1187-1191
[Abstract][Full Text]
Walsh, T. S., Saleh, E.-E.-D.
(2006). Anaemia during critical illness. Br J Anaesth
97: 278-291
[Full Text]
Bierer, R., Peceny, M. C., Hartenberger, C. H., Ohls, R. K.
(2006). Erythropoietin Concentrations and Neurodevelopmental Outcome in Preterm Infants. Pediatrics
118: e635-e640
[Abstract][Full Text]
Eikelboom, J. W., Mehta, S. R., Anand, S. S., Xie, C., Fox, K. A.A., Yusuf, S.
(2006). Adverse Impact of Bleeding on Prognosis in Patients With Acute Coronary Syndromes. Circulation
114: 774-782
[Abstract][Full Text]
A correction has been published: N Engl J Med 1999;340(13):1056.
20 (8.7 percent in the restrictive-strategy group and 16.1 percent in the liberal-strategy group, P=0.03) — and among patients who were less than 55 years of age (5.7 percent and 13.0 percent, respectively; P=0.02), but not among patients with clinically significant cardiac disease (20.5 percent and 22.9 percent, respectively; P=0.69). The mortality rate during hospitalization was significantly lower in the restrictive-strategy group (22.2 percent vs. 28.1 percent, P=0.05). 
