Evidence map›Paper›PMID 39979754›Full record

Trial reportInternal and emergency medicine2025

Optimal hemoglobin threshold for blood transfusions in sepsis and septic shock: a retrospective analysis.

Chairat Permpikul, Jakpanee Tanksinmankhong, Surat Tongyoo, Thummaporn Naorungroj, Tanuwong Viarasilpa, Khemajira Karaketklang

Abstract readClinical Trial
In one paragraph

Trial report in Internal and emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Chairat PermpikulDivision of Critical Care, Department of Internal Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkok Noi, Bangkok, 10700, Thailand.ORCID 0000-0001-5491-6987
Jakpanee TanksinmankhongDepartment of Internal Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Surat TongyooDivision of Critical Care, Department of Internal Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkok Noi, Bangkok, 10700, Thailand. surat.ton@mahidol.ac.th.ORCID 0000-0003-3772-2990
Thummaporn NaorungrojDivision of Critical Care, Department of Internal Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkok Noi, Bangkok, 10700, Thailand.
Tanuwong ViarasilpaDivision of Critical Care, Department of Internal Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkok Noi, Bangkok, 10700, Thailand.
Khemajira KaraketklangDepartment of Internal Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Funding

Siriraj Critical Care Research Fund SiCCM 012
6 · The paper itself

Abstract

Transfusions of red blood cells (RBCs) are crucial for improving tissue oxygenation in anemic patients with sepsis. Nevertheless, the debate continues over the ideal hemoglobin level for transfusions. This study aimed to assess the impact of different hemoglobin levels on the outcomes of patients with sepsis who received transfusions. This retrospective analysis included adult patients with sepsis treated in the general medical ward and intensive care unit at a University affiliate hospital. Patients needing RBC transfusions were included. The primary outcome was the 28-day mortality rate. From March 2018 to January 2022, 806 patients were studied. Of these, 480 (59.6%) were transfused at hemoglobin levels of 7-9 g/dL ("liberal group"), while 326 (40.4%) received RBC transfusions when their hemoglobin was < 7 g/dL ("restrictive group"). Mean hemoglobin levels at transfusion were 8.1 ± 0.8 g/dL and 6.3 ± 0.8 g/dL for each group, respectively(P < 0.001). On day 28, the liberal group had a mortality rate of 51.2% (246 patients), compared to 59.2% (193 patients) in the restrictive group (Odds ratio [OR] 0.88, 95% confidence interval [CI] 0.79-0.98, P = 0.031). Adjusted comparisons showed 46.8% mortality in the liberal group (141/301patients) versus 59.3% in the restrictive group (178/300patients) at 28 days (OR 0.78, 95% CI 0.66-0.92, P = 0.002). Multivariate analysis revealed transfusion at hemoglobin 7-9 g/dL as an independent variable linked to lower 28-day mortality (OR 0.70, 95% CI 0.49-0.99, P = 0.042). Other factors correlated with 28-day mortality were platelet counts ≤ 150 × 10

Indexed as

Blood TransfusionErythrocyte TransfusionHemoglobinsSepsisShock, SepticAgedFemaleHumansMaleMiddle AgedRetrospective StudiesHemoglobinsHemoglobin levelLiberal blood transfusionRBC transfusionRestrictive blood transfusionSepsisSeptic shock

Identifiers

PMID39979754
PMCPMC12009219

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.