Hemodynamics, fluids & transfusion
Beyond Hemoglobin Thresholds: A Retrospective Cohort Analysis of RBC Transfusion Decisions in ICU Patients
Authors' conclusion
The decision to transfuse RBC during ICU care is multifactorial and not adequately explained by the pre-transfusion hemoglobin concentration alone.
Study context
- Population
- Adult ICU patients ≥18 years, 3 ICUs, January 2018 to June 2023
- Participants
- 18,544 patients · 19,439 ICU encounters
- Outcome
- Likelihood of RBC transfusion during each time interval of care
Methodological detailsdecision time-interval analysis, multicentre (3 ICUs)
- Decision time-interval analysis
- Multicentre (3 ICUs)
Main finding
As reported in the abstract
Likelihood of RBC transfusion
- Pre-transfusion hemoglobin did not fully account for the likelihood of transfusion
- Factors associated with increased likelihood of transfusion (hemoglobin 7-9 g/dL): hemoglobin decline from prior value, chest tube drainage, concurrent plasma or platelet transfusion, prior RBC transfusion, ECMO, vasopressors, mechanical ventilation, RRT, patient age, male sex
- ORs for principal clinical factors significantly different in medical, surgical and cardiac surgery ICUs
- 199,296 decision time-intervals analysed
- Multivariable logistic regression (generalized linear mixed-effects or generalized estimating equations)
Observational data: associations, not effects.
Original publication
Beyond Hemoglobin Thresholds: A Retrospective Cohort Analysis of RBC Transfusion Decisions in ICU Patients. Crit Care Med. Published 28 March 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →