The effect of liberal and restrictive transfusion practices on survival in oncology patients with sepsis in the intensive care unit

The effect of liberal and restrictive transfusion practices on survival in oncology patients with sepsis in the intensive care unit. Download PDF Abstract Red blood cell (RBC) transfusion is a commonly usesd supportive therapy in intensive care units (ICUs). The optimal transfusion practice in oncologic patients with sepsis remains controversial.

This study aimed to compare the clinical outcomes of liberal versus restrictive transfusion practices in oncologic patients with sepsis admitted to the ICU. This retrospective, non-randomized study included oncologic patients with sepsis admitted to the ICU between 2014 and 2023. Patients were classified as having restrictive or liberal transfusion practice based on serial hemoglobin (Hb) measurements and corresponding decisions to administer or withhold RBC transfusion, reflecting lower (< 7–8 g/dL) or higher (≤ 9–10 g/dL) Hb thresholds, respectively.

Among patients who did not receive RBC transfusion, withholding transfusion at Hb levels of 7.1–8.9 g/dL and 9.1–10.0 g/dL was classified as restrictive and liberal transfusion practice, respectively; thus, actual receipt of RBC transfusion was not required for group assignment. Patients with mixed or otherwise unclassifiable transfusion practices were excluded. As treatment decisions were determined by treating physicians, the approach may introduce selection bias.

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