The red blood cell transfusion (RBCT) threshold in sepsis patients is still debatable. A study presented an overview of the advantages and hazards of RBCT. It focused on the most recent research addressing this debate, such as randomized controlled trials dealing with early goal-directed treatment, randomized controlled trials comparing liberal vs. restrictive transfusion techniques, and cohort studies evaluating the impact of RBCT.
According to the findings of the studies, it no longer supports a 10 g/dL transfusion threshold during the early stages of septic shock. Similarly, after early stabilization, most septic patients may be maintained with a limited transfusion approach based on a hemoglobin threshold of 7 g/dL. If patients are not stabilized, or if they are in danger of bleeding, have cardiac ischemia, or are oncohematologic patients with probable hemostasis abnormalities, a more liberal transfusion strategy should be used.
To decide on RBCT in septic patients, triggers other than hemoglobin levels, more related to macrocirculation or microcirculation failures, should be developed.
Reference:journals.lww.com/clinpulm/Abstract/2018/07000/Transfusion_for_Patients_With_Sepsis_in_2018.4.aspx
