The DOI matches its Crossref record; 29 of the 29 references it cites were found in a registry or an index.
A Multicenter, Randomized, Controlled Clinical Trial of Transfusion Requirements in Critical Care
Open accessAbstract
BACKGROUND: To determine whether a restrictive strategy of red-cell transfusion and a liberal strategy produced equivalent results in critically ill patients, we compared the rates of death from all causes at 30 days and the severity of organ dysfunction. METHODS: We enrolled 838 critically ill patients with euvolemia after initial treatment who had hemoglobin concentrations of less than 9.0 g per deciliter within 72 hours after admission to the intensive care unit and randomly assigned 418 patients to a restrictive strategy of transfusion, in which red cells were transfused if the hemoglobin concentration dropped below 7.0 g per deciliter and hemoglobin concentrations were maintained at 7.0 to 9.0 g per deciliter, and 420 patients to a liberal strategy, in which transfusions were given when the hemoglobin concentration fell below 10.0 g per deciliter and hemoglobin concentrations were maintained at 10.0 to 12.0 g per deciliter. RESULTS: Overall, 30-day mortality was similar in the two groups (18.7 percent vs. 23.3 percent, P= 0.11). However, the rates were significantly lower with the restrictive transfusion strategy among patients who were less acutely ill -- those with an Acute Physiology and Chronic Health Evaluation II score of < or =20 (8.7 percent in the restrictive-strategy group and 16.1 percent in the liberal-strategy group; P=0.03) -- and among patients who were less than 55 years of age (5.7 percent and 13.0 percent, respectively; P=0.02), but not among patients with clinically significant cardiac disease (20.5 percent and 22.9 percent, respectively; P=0.69). The mortality rate during hospitalization was significantly lower in the restrictive-strategy group (22.3 percent vs. 28.1 percent, P=0.05). CONCLUSIONS: A restrictive strategy of red-cell transfusion is at least as effective as and possibly superior to a liberal transfusion strategy in critically ill patients, with the possible exception of patients with acute myocardial infarction and unstable angina.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“The Transfusion requirements in in Critical Care trial (TRICC), which compared a restrictive transfusion threshold of 70 g/L versus 100 g/L in 838 euvolemic ICU patients, demonstrated no difference in the primary outcome (30-day mortality).”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [484]
In the citing paper
“The results showed similar 90-day mortality, ischaemic events, and use of life support in the two treatment groups with fewer transfusions in the lower-threshold group.”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [484]
In the citing paper
“In the subgroup of 218 patients with sepsis or septic shock 30-day mortality was similar in the two groups (22.8% in the restrictive group vs. 29.7% in the liberal group, p = 0.36).”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [484]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Knaus, W. A., Draper, E. A., Wagner, D. P., & Zimmerman, J. E. (1985) · Critical Care Medicine · doi:10.1097/00003246-198510000-00009 · Cited by 15,518
APACHE II-A Severity of Disease Classification System
Knaus, W. A., Draper, E. A., Wagner, D. P., & Zimmerman, J. E. (1986) · Critical Care Medicine · doi:10.1097/00003246-198608000-00028 · Cited by 13,379
A Trial of Goal-Oriented Hemodynamic Therapy in Critically Ill Patients
Gattinoni, L., Brazzi, L., Pelosi, P. P., Latini, R., Tognoni, G., Pesenti, A. M., & Fumagalli, R. (1995) · New England Journal of Medicine · doi:10.1056/nejm199510193331601 · Cited by 1,486
Effect of anaemia and cardiovascular disease on surgical mortality and morbidity
Carson, J. L., Duff, A., Poses, R. M., Berlin, J. A., Spence, R. K., Trout, R., Noveck, H., & Strom, B. L. (1996) · The Lancet · doi:10.1016/s0140-6736(96)04330-9 · Cited by 994
Vichinsky, E. P., Haberkern, C. M., Neumayr, L., Earles, A. N., Black, D. M., Koshy, M., Pegelow, C. H., Abboud, M. R., Ohene‐Frempong, K., & Iyer, R. V. (1995) · New England Journal of Medicine · doi:10.1056/nejm199507273330402 · Cited by 644
van de Watering, L. M. G., Hermans, J., Houbiers, J. G. A., van den Broek, P. J., Bouter, H., Boer, F., Harvey, M. S., Huysmans, H. A., & Brand, A. (1998) · Circulation · doi:10.1161/01.cir.97.6.562 · Cited by 553
RBC transfusion in the ICU. Is there a reason?
Corwin, H., Parsonnet, K. C., & Gettinger, A. (1995) · Chest · doi:10.1378/chest.108.3.767 · Cited by 390
Biologic effects of leukocytes present in transfused cellular blood products
Bordin, J. O., Heddle, N., & Blajchman, M. A. (1994) · Blood · doi:10.1182/blood.v84.6.1703.bloodjournal8461703 · Cited by 357
Self-citationHébert, P. C., Wells, G. A., Tweeddale, M., Martin, C. M., Marshall, J., Pham, B., Blajchman, M. A., Schweitzer, I., & Pagliarello, G. (1997) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.155.5.9154866 · Cited by 348
Self-citationPractice Strategies for Elective Red Blood Cell Transfusion
(1992) · Annals of Internal Medicine · doi:10.7326/0003-4819-116-5-403 · Cited by 342
Biologic effects of leukocytes present in transfused cellular blood products
Bordin, J. O., Heddle, N., & Blajchman, M. A. (1994) · Blood · doi:10.1182/blood.v84.6.1703.1703 · Cited by 340
Self-citationMaximizing oxygen delivery in critically ill patients
Heyland, D. K., Cook, D. J., King, D. B. M., Kernerman, P., & Brun‐Buisson, C. (1996) · Critical Care Medicine · doi:10.1097/00003246-199603000-00025 · Cited by 340
Comparison of two transfusion strategies after elective operations for myocardial revascularization
Johnson, R. G., Thurer, R. L., Kruskall, M. S., Sirois, C. A., Gervino, E. V., Critchlow, J. F., & Weintraub, R. M. (1992) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/s0022-5223(19)34782-8 · Cited by 237
Effect of early blood transfusion on gastrointestinal haemorrhage
Blair, S. D., Janvrin, S. B., McCollum, C. N., & Greenhalgh, R. M. (1986) · British journal of surgery · doi:10.1002/bjs.1800731007 · Cited by 211
Hébert, P. C., Drummond, A. J., Singer, J., Bernard, G. R., & Russell, J. A. (1993) · CHEST Journal · doi:10.1378/chest.104.1.230 · Cited by 199
Self-citationA Canadian survey of transfusion practices in critically ill patients
Hébert, P. C., Wells, G. A., Martin, C. M., Tweeddale, M., Marshall, J. C., Blajchman, M. A., Pagliarello, G., Schweitzer, I., & Calder, L. A. (1998) · Critical Care Medicine · doi:10.1097/00003246-199803000-00019 · Cited by 185
Self-citationTransfusion Requirements in Critical Care
Hébert, P. C. (1995) · JAMA · doi:10.1001/jama.1995.03520420055038 · Cited by 181
Self-citationThe Oxygen Delivery/Consumption Controversy. Approaches to Management of the Critically Ill
Russell, J. A., & Phang, P. T. (1994) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.149.2.8306058 · Cited by 171
Limitations of blood conservation
Weisel, R. D., Charlesworth, D. C., Mickleborough, L. L., Fremes, S. E., Ivanov, J., Mickle, D. A. G., Teasdale, S. J., Glynn, M. F. X., Scully, H. E., Goldman, B. S., et al. (1984) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/s0022-5223(19)38384-9 · Cited by 115
Red cell deformability is an early indicator of infection.
Langenfeld, J. E., Livingston, D. H., & Machiedo, G. W. (1991) · PubMed · Cited by 77
Review of the clinical practice literature on allogeneic red blood cell transfusion
Hébert, P. C., Schweitzer, I., Calder, L. A., Blajchman, M. A., & Giulivi, A. (1997) · Europe PMC (PubMed Central) · Cited by 70
Self-citationMarshall, M. F., Schwenzer, K. J., ORSINA, M., Fletcher, J. C., & Durbin, C. G. (1992) · Critical Care Medicine · doi:10.1097/00003246-199203000-00016 · Cited by 69
Reduced RBC versus plasma microvascular flow due to endotoxin.
Ch, B., Fr, W., & Sutton, E. T. (1986) · PubMed · Cited by 43
Transfusion requirements in critical care. A pilot study. Canadian Critical Care Trials Group
Hébert, P. C. (1995) · JAMA · doi:10.1001/jama.273.18.1439 · Cited by 39
Self-citationA trial of goal- oriented hemodynamic therapy in critically ill patients
Gattinoni, L., Brazzi, L., Pelosi, P., Latini, R., Tognoni, G., Pesenti, A., & Fumagalli, R. (1996) · Resuscitation · doi:10.1016/0300-9572(96)83779-8
Limitations of Blood Conservation
WEISEL, R. D., CHARLESWORTH, D. C., MICKLEBOROUGH, L. L., FREMES, S. E., IVANOV, J., MICKLE, D. A. G., TEASDALE, S. J., GLYNN, M. F. X., SCULLY, H. E., GOLDMAN, B. S., et al. (1985) · Survey of Anesthesiology · doi:10.1097/00132586-198504000-00039
THE EFFECT OF EARLY BLOOD TRANSFUSION ON THE OUTCOME OF GASTROINTESTINAL HAEMORRHAGE
Blair, S. D., Javanvrin, S. B., McCollum, C. N., & Greenhalgh, R. M. (1987) · Thrombosis and Haemostasis · doi:10.1055/s-0038-1644157
Research works printed but not linked: 4
- Langenfeld JE, 1991, Surgery, 110, 398
- Baker CH, 1986, Circ Shock, 20, 127
- Friedman LM, Furberg CD, DeMets DL. Fundamentals of clinical trials. 3rd ed. St. Louis: Mosby-Year Book, 1996.
- Hebert PC, 1997, Can Med Assoc J, 156, S9
Cited by
Sorted by citations
Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock
Dellinger, R. P., Levy, M. M., Rhodes, A., Annane, D., Gerlach, H., Opal, S. M., Sevransky, J. E., Sprung, C. L., Douglas, I. S., Jaeschke, R., et al. (2013) · Critical Care Medicine · doi:10.1097/ccm.0b013e31827e83af · Cited by 9,694
Roffi, M., Patrono, C., Collet, J.-P., Mueller, C., Valgimigli, M., Andreotti, F., Bax, J. J., Borger, M. A., Brotons, C., Chew, D. P., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehv320 · Cited by 8,261
Dellinger, R. P., Levy, M. M., Rhodes, A., Annane, D., Gerlach, H., Opal, S. M., Sevransky, J., Sprung, C. L., Douglas, I. S., Jaeschke, R., et al. (2013) · Intensive Care Medicine · doi:10.1007/s00134-012-2769-8 · Cited by 7,371
Dellinger, R. P., Levy, M. M., Carlet, J. M., Bion, J., Parker, M. M., Jaeschke, R., Reinhart, K., Angus, D. C., Brun‐Buisson, C., Beale, R. J., et al. (2007) · Intensive Care Medicine · doi:10.1007/s00134-007-0934-2 · Cited by 6,789
Self-citation(2005) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200405-644st · Cited by 5,932
Metadata
- Authors
- Hébert, P. C., Wells, G., Blajchman, M. A., Marshall, J., Martin, C., Pagliarello, G., Tweeddale, M., Schweitzer, I., & Yetisir, E.
- Affiliations
- University of Ottawa (CA)
- McMaster University (CA)
- University of Toronto (CA)
- Western University (CA)
- University of British Columbia (CA)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1999-02-11
- Volume
- 340
- Issue
- 6
- Pages
- 409-417
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W127034668
- Cited by
- 5,187
- References
- 24
- Citations by year
- 2026: 88 · 2025: 121 · 2024: 123 · 2023: 116 · 2022: 124 · 2021: 137 · 2020: 188 · 2019: 173 · 2018: 168 · 2017: 231 · 2016: 256 · 2015: 246 · 2014: 287 · 2013: 269 · 2012: 254
- FWCI
- 79.72
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Hamilton Health Sciences
- University of Waterloo
- Jewish General Hospital
- Topics
- Health Sciences › Medicine › Hematology › Blood transfusion and management
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Trauma, Hemostasis, Coagulopathy, Resuscitation
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Keywords
- red blood cell transfusion, restrictive transfusion, liberal transfusion, critically ill patients, hemoglobin threshold, 30-day mortality, organ dysfunction, APACHE II score, age, heart disease, acute myocardial infarction, unstable angina
- MeSH terms
- Adult, Aged, Critical Care, Female, Hemoglobins, Humans, Intensive Care Units, Male, Middle Aged, Multiple Organ Failure, Logistic Models, Survival Analysis, Critical Illness, Hospital Mortality, Erythrocyte Transfusion, APACHE
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
