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TRICC
About the Trial
The Transfusion Requirements in Critical Care trial randomized 838 euvolemic ICU patients to restrictive transfusion at hemoglobin under 7 versus liberal at under 10. The restrictive strategy was at least as safe, with a possible mortality benefit in younger and less sick patients. For 40 years the 10 30 rule, transfuse to keep hemoglobin at 10, had ruled ICUs. TRICC dismantled it, showing stored blood carries risks beyond infection: immunomodulation, inflammation, impaired oxygen delivery. Later trials, including TRISS in septic shock and a Barcelona trial in upper gastrointestinal bleeding, supported restrictive strategies in other settings. The trial helped drive patient blood management programs worldwide.
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