Different hemoglobin thresholds for transfusion in patients with severe sepsis and septic shock

Introduction Hemoglobin (Hb) level transfusion thresholds in patients with sepsis who develop anemia have long been a matter of debate. In a randomized controlled trial comparing thresholds of Hb ≤ 7 g/dL vs. ≤ 9 g/dL in patients with severe sepsis and septic shock, comparable outcomes including mortality were obtained [1], while in an observational study of those patients, higher Hb levels were associated with lower mortality [2]. During the resuscitation phase of septic shock, a substantial number of clinicians may have used a higher threshold of hemoglobin at 10 g/dL, as recommended in the Surviving Sepsis Campaign Guideline 2008 [3].