Transfusion in Critical Care

Hebert 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. Study found that the transfusion threshold of 10gm/dl may be inappropriately high in patients without cardiovascular disease.
PMID:  9971864
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Corwin HL, Gettinger A, Pearl RG, et al. Efficacy of recombinant human erythropoietin in critically ill patients. JAMA 2002;288:2827-35. Placebo-controlled RCT of 1300 critically ill patients found weekly administration of 40,000U of recombinant human EPO resulted in a 19% reduction in total units of RBC transfused. No difference seen in morbidity or mortality. PMID:  14668256
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Corwin HL, Gettinger A, Fabian TC, et al. Efficacy and safety of epoetin alfa in critically ill patients. N Engl J Med  2007; 357:965-76. In contrast to the 2002 study by Corwin et al, this study of 1,460 MICU and SICU patients found use of epo did not reduce red cell transfusions, but did increase the risk of thrombotic events. This difference may be related to more stringent transfusion practices in recent years. Trauma patients randomized to epo unexpectedly had lower mortality.
PMID:  17804841
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