Oh, what a surprise! Another study revealing that maybe, just maybe, we’ve been a tad overzealous with the whole red blood cell (RBC) transfusion thing in the intensive care units (ICUs). Who would’ve thought that pumping critically ill patients full of RBCs could have some downsides? Let’s dive into this groundbreaking revelation, shall we?

So, the geniuses at a large academic tertiary hospital decided to take a stroll down memory lane, looking at records from March 2018 to February 2020. They split adult ICU patients into two groups: those who had the pleasure of receiving one or more RBC transfusions during their first month of vacation in the ICU, and those who, sadly, missed out on this opportunity.

And what did they find? Out of 2159 patients, 594 got to join the exclusive transfusion club. But here’s the kicker: those with a pre-transfusion hemoglobin (Hb) level higher than a 9th-grade reading score (i.e., >9 g/dL) had about twice the risk of dying in the ICU. Meanwhile, factors like being older than the hospital itself (OR adjusted=1.03) and having an APACHE II score higher than your average golf score (OR adjusted=1.08) also upped the ante on meeting the Grim Reaper.

The moral of the story? Maybe, just maybe, ICU docs should think twice before ordering a round of RBCs, especially if the patient’s Hb level is already in the green. And, in a shocking turn of events, it turns out that doing things based on evidence rather than a hunch might actually improve patient outcomes. Who knew?

But, before we get too excited, let’s not forget the classic disclaimer: this is a single-center and retrospective study. So, take it with a grain of salt, or better yet, a whole salt shaker.