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Therapeutics/Prevention
Systematic review with meta analysis
Restrictive red blood cell transfusion strategies appear safe in most clinical settings
  1. Nareg H Roubinian1,
  2. Jeffrey L Carson2
  1. 1Blood Systems Research Institute, San Francisco, California, USA
  2. 2Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
  1. Correspondence to : Dr Jeffrey L Carson, Department of Medicine, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street, New Brunswick, NJ 08901, USA; carson{at}rwjms.rutgers.edu

https://doi.org/10.1136/ebmed-2015-110218

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    Commentary on: Holst LB, Petersen MW, Haase N, et al. Restrictive versus liberal transfusion strategy for red blood cell transfusion: systematic review of randomised trials with meta-analysis and trial sequential analysis. BMJ 2015;350:h1354.OpenUrlAbstract/FREE Full Text

    Context

    Substantial progress has been made in generating data to make evidence-based recommendations for red blood cell (RBC) transfusion. Findings from clinical trials suggest that in most clinical settings, a restrictive transfusion strategy, where RBCs are transfused once haemoglobin levels fall below either 7 or 8 g/dL, does not impact mortality compared with liberal transfusion where RBCs are transfused when haemoglobin levels fall below 9–10 g/dL.1 This meta-analysis, incorporating data from five recently published clinical trials, was used to compare the overall risk of death and other adverse events of liberal and restrictive transfusion strategies.

    Methods

    The authors performed a study-level meta-analysis on 31 prospective randomised controlled trials of hospitalised patients (n=9813) where …

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    Footnotes

    • Competing interests JLC has authored a systematic review published in the Cochrane database and plans to update it. There has been a large clinical trial published since this paper was published.

    • Provenance and peer review Commissioned; internally peer reviewed.