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Restrictive Blood Transfusion Linked to Lower Infection Risk — Physician’s First Watch

Medical News |
April 2, 2014

Restrictive Blood Transfusion Linked to Lower Infection Risk

By Kelly Young

A restrictive strategy of red blood cell transfusion is associated with lower infection risk for hospitalized patients, compared with a more liberal transfusion strategy, a JAMA meta-analysis finds.

Researchers analyzed the results of 18 randomized trials of 7600 patients that assessed liberal versus restrictive transfusion approaches. Thresholds varied, but most trials compared hemoglobin transfusion thresholds of 7 to 8 g/dL (restrictive) with 9 to 11 g/dL (liberal). Hospital-associated infections occurred in 16.9% of liberal-transfusion patients and 11.8% of restrictive-transfusion patients. Thirty-eight patients needed to be treated with a restrictive strategy to prevent one serious infection. A subset of eight trials that used leukocyte reduction did not see an additional benefit.

An editorialist concludes: "Clinical trials are needed to establish the optimal transfusion thresholds, to provide additional information about the risks and benefits of [red blood cell] transfusion, and to determine how best to use" it.

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