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Restrictive or Liberal Red-Cell Transfusion for Cardiac Surgery

Sunday, November 12, 2017

Submitted by

Mark Ferguson

Source

Source Name: New England Journal of Medicine

Source URL: http://www.nejm.org/doi/full/10.1056/NEJMoa1711818

Author(s)

C. David Mazer, Richard P. Whitlock, Dean A. Fergusson, Judith Hall, Emilie Belley-Cote, Katherine Connolly, Boris Khanykin, Alexander J. Gregory, Étienne de Médicis, Shay McGuinness, Alistair Royse, François M. Carrier, Paul J. Young, Juan C. Villar, Hilary P. Grocott, Manfred D. Seeberger, Stephen Fremes, François Lellouche, Summer Syed, Kelly Byrne, Sean M. Bagshaw, Nian C. Hwang, Chirag Mehta, Thomas W. Painter, Colin Royse, Subodh Verma, Gregory M.T. Hare, Ashley Cohen, Kevin E. Thorpe, Peter Jüni, and Nadine Shehata, for the TRICS Investigators and Perioperative Anesthesia Clinical Trials Group

This randomized trial evaluated restricted (threshold of Hgb <7.5 at induction of anesthesia ) versus liberal (Hgb <9.5 at induction of anesthesia or <8.5 on arrival in ICU) for patients undergoing cardiac surgery who had a EuroSCORE of 6 or more. The composite outcome was death, MI, stroke, or new onset renal failure. Transfusion occurred in 52% of the restricted group and 73% of the liberal group. Outcomes were similar between these moderate-to-high risk groups.