Restrictive or Liberal Red-Cell Transfusion for Cardiac Surgery

The avoidance of unnecessary blood transfusion is a high priority; therefore, determining safe thresholds for transfusion is imperative. Among the highest recipients of red-cell transfusion are patients undergoing cardiac surgery, with a substantial proportion of the total blood supply used by this group. Whether a restrictive approach to intraoperative and postoperative transfusion in cardiac surgery safely achieves outcomes similar to those achieved by means of a more liberal approach remains unclear.

N Engl J Med. 2017 Nov 30;377(22):2133-2144. doi: 10.1056/NEJMoa1711818