Packed red blood cell transfusions in critically ill infants and children: is it time for a restructive transfusion strategy?

Although a restrictive transfusion policy is being increasingly advocated during critical illness in the past few years, the optimal hemoglobin level for red blood cell [RBC] transfusions is not known in critically ill infants and children. We conducted a prospective comparative randomized trial to test the hypothesis that a restrictive RBC transfusion strategy would be as safe as liberal transfusion strategy in the pediatric intensive care unit [PICU]. The primary outcome measure was PICU mortality following randomization, three hundred and nine patients with a hemoglobin concentration