Red cell transfusion triggers in critically ill patients: time for some new TRICCs?
Current evidence suggests that critically ill patients tolerate anaemia well and that blood transfusions may increase the risk of adverse outcomes. Dr Sakr and colleagues present a contradictory analysis of a surgical ICU cohort, finding an association between blood transfusions and lower hospital mortality after adjustment for a range of potential confounders. Analyses of this kind are interesting and provocative, but are limited by residual confounding and bias by indication. The data emphasise the need for additional high quality trials of transfusion practice in critical care.
Walsh
Timothy S
TS
Anaesthetics, Critical Care and Pain Medicine, Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh EH16 2SA, UK. twalsh@staffmail.ed.ac.uk
D000740:Anemia; D002986:Clinical Trials as Topic; D003422:Critical Care; D016638:Critical Illness; D017707:Erythrocyte Transfusion / Q000009:adverse effects / Q000592:standards*; D017408:Guidelines as Topic; D017052:Hospital Mortality; D006801:Humans