6/30/23, 2:20 AM TRISS Pathway Feedback Search Clinical Topics Home Studies TRISS TRISS Disease Disease Sepsis and septic shock Transfusion strategies in critical Trial question What is the effect of lower Hgb threshold for transfusion in patients with septic shock? Study design Multi-center Open label RCT Population Characteristics of study participants 47.0% female N = 998 53.0% male 998 patients (467 female, 531 male) Inclusion criteria: patients in the ICU who had septic shock and a Hgb concentration 9 g/dL Key exclusion criteria: declined transfusion, previous adverse reaction to transfusion, received blood transfusion in ICU, acute coronary syndrome, life-threatening bleeding, and acute burn injury Interventions N=502 restrictive blood transfusion therapy (1 unit of leukoreduced red cells when Hgb level 7 g/dL) N=496 liberal blood transfusion therapy (1 unit of leukoreduced red cells when Hgb level 9/dL) Primary outcome https://web.pathway.md/studies/recMe9UDfEHKIv9sO 1/2 6/30/23, 2:20 AM TRISS Pathway Death at 90 days 45.0 % 45 43 33.8 % 22.5 % 11.3 % No significant difference 0.0 % Restrictive blood transfusion therapy Liberal blood transfusion therapy No significant difference in death at 90 days (43% vs. 45%; RR 0.94, 95% CI 0.78 to 1.09) Secondary outcomes No significant difference in use of life support at day 28 (16.1% vs. 19.9%; RR 0.77, 95% CI 0.54 to 1.09) No significant difference in ischemic events in the ICU (7.2% vs. 8%; RR 0.9, 95% CI 0.58 to 1.39) Safety outcomes No significant differences in severe adverse reaction (0% vs. 0.2%, p=1.00). Conclusion In patients in the ICU who had septic shock and a Hgb concentration 9 g/dL, restrictive blood transfusion therapy was not superior to liberal blood transfusion therapy with respect to death at 90 days. Reference Holst LB, Haase N, Wetterslev J et al. Lower versus higher hemoglobin threshold for transfusion in septic shock. N Engl J Med. 2014 Oct 9;371(15):1381-91. Open reference URL https://web.pathway.md/studies/recMe9UDfEHKIv9sO 2/2