TRISS

TRISS

What is the effect of lower Hemoglobin threshold for transfusion in patients with septic shock?

Study design

Population

• 998 patients (467 female, 531 male)
• Inclusion criteria: patients in the ICU (ICU) who had septic shock and a Hgb concentration < 9 g/dL
• Key exclusion criteria: declined transfusion, previous adverse reaction to transfusion, received blood transfusion in ICU, ACS, life-threatening bleeding, and acute burn injury

Interventions

• N=502 restrictive blood transfusion therapy (1 unit of leukoreduced red cells when Hgb level < 7 g/dL)
• N=496 liberal blood transfusion therapy (1 unit of leukoreduced red cells when Hgb level < 9/dL)

Primary outcome

Secondary outcomes

• No significant difference in use of life support at day 28
  (16.1% vs. 19.9%; RR 0.77, 95% CI 0.54 to 1.09)
• No significant difference in ischemic events in the ICU
  (7.2% vs. 8%; RR 0.9, 95% CI 0.58 to 1.39)

Safety outcomes

No significant differences in severe adverse reaction (0% vs. 0.2%, p=1.00).

Conclusion

In patients in the ICU (ICU) who had septic shock and a Hgb concentration ≤ 9 g/dL, restrictive blood transfusion therapy was not superior to liberal blood transfusion therapy with respect to death at 90 days.