Anaemia and transfusion — data viva

Restrictive threshold. Stable adult without ACS: TRICC transfused below 7.0 g/dL versus below 10.0 g/dL in euvolaemic critical illness — 30-day mortality similar (18.7 versus 23.3 per cent).^[1] Give one unit then reassess — TRISS delivered one leukoreduced unit at the trigger.^[6] Symptomatic IHD: FOCUS restrictive arm was symptoms or haemoglobin below 8 g/dL, not a liberal 10 g/dL target.^[4] Active haemorrhage: treat bleeding physiology, not the isolated number.

MHP. If massive haemorrhage, activate protocol, balanced products, source control; PROPPR supports early 1:1:1 versus 1:1:2 for haemostasis and fewer exsanguination deaths, without a significant 24-hour or 30-day mortality difference.^[2]

TACO vs TRALI. Hypertensive hypoxia, raised JVP, response to diuretic → TACO (leading cause of reaction-related death).^[3] Non-cardiogenic pulmonary oedema, often hypotensive, no overload → TRALI — report all post-transfusion pulmonary oedema so the service can classify TRALI, TACO, ARDS or indistinguishable.^[7] Stop transfusion, ABC, notify blood bank.