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Transfusion in Critical Care

Hébert P, Wells G, Blajchmann M, et al. A multicenter randomized controlled clinical trial of transfusion requirements in critical care. N Engl J Med 1999;340:409-17. Landmark study found equal mortality using transfusion thresholds of 7 gm/dl and 10gm/dl and higher mortality with liberal transfusion among younger and less ill patients.

PMID: 9971864

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Villanueva C, Colomo A, Bosch A, et al. Transfusion strategies for acute upper gastrointestinal bleeding. N Engl J Med. 2013; 368:11-21. A large multi-center trial that found a hemoglobin goal of 7 mg/dL during acute upper gastrointestinal bleed resulted in a lower risk of re-bleeding, adverse events, and a decreased hazard ratio for death at 6 weeks when compared with a 9 mg/dL target. Patients with rapid exsanguination were excluded. The mortality benefit appears greatest in patients with Child-Pugh class A or B cirrhosis.

PMID: 23281973

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