Anemia: TRISS (2014) ( Transfusion thresholds in Septic Shock)

Question 1

TRISS Clinical Q

Answer 1

In patients with septic shock, how does a restrictive transfusion strategy (Hgb ≤ 7 g/dL) compare with a liberal transfusion strategy (Hgb ≤ 9 g/dL) in terms of 90-day mortality?

Question 2

TRISS Bottom Line

Answer 2

Patients with septic shock who underwent transfusion at a Hgb threshold of 7 g/dL had similar mortality at 90 days but used 50% fewer units of blood compared with those who underwent transfusion at a Hgb threshold of 9 g/dL.

Question 3

TRISS Primary Outcome

Answer 3

90 day mortality

Question 4

TRISS Criticisms

Answer 4

• Did not have systematic approach for evaluating rate of MI
• Not double blinded
• Unclear effects of leukoreduced blood as transfusion product

Question 5

TRISS inclusion criteria

Answer 5

• Age ≥18 years in the ICU
• Septic shock
• Hgb 9 g/dL or less