I’ve previously written a two posts on blood transfusions from a surgeons perspective (End of the blood reign and A bloody mess) and I was therefore thrilled when I stumbled upon this Cochrane review that concludes:
The findings provide good evidence that transfusions with allogeneic RBCs can be avoided in most patients with haemoglobin thresholds above 7 g/dL to 8 g/dL.
They included 31 trials with a total of more than 12,000 patients and found that 30-day mortality wasn’t affected. They also didn’t find any difference regarding the incidence of complications. I was a little bummed that they didn’t find a reduced prevalence of infectious diseases with the more restrictive approach since blood is well-known to be a powerful immune suppressor. I guess the fact that the restrictive approach reduced the transfusions by 2/5 should be enough for my colleagues to reconsider their previous beliefs.
