Background: The primary therapeutic approach for promptly
increasing haemoglobin concentration is red blood cell transfusion. However, the risk
associated with RBC transfusion and the overall accessibility exhibit significant
variation. Objective: This meta-analysis evaluates the comparison and outcome of
restrictive and liberal transfusion strategies in intensive care unit. Methods: A
comprehensive search was carried out on various databases, including CENTRAL, PubMed,
MEDLINE, and ScienceDirect for randomized control clinical trials evaluating the
comparison of clinical outcomes of restrictive and liberal transfusion strategies in
critically ill patients. The primary outcomes measure was mortality, which included ICU
mortality and hospital mortality. In addition, data were pooled using random-effect
models and heterogeneity was evaluated through I² statistics. Results: Out of 15
eligible RCTs obtained, involving 12,439 patients. The result demonstrated no
significant difference of restrictive red-cell transfusion strategy over liberal
red-cell transfusion strategy in reducing mortality outcomes with a pooled effect size
(relative risk [RR] 0.92; 95% confidence interval [CI] 0.78 – 1.08; I2 = 0%, indicating
minimal to no difference. Similarly, analyses of secondary outcomes identified no
significant differences in several clinical results. Conclusion: This present
meta-analysis provides evidence that restrictive red-cell transfusion strategy
doesn't significantly difference in overall mortality and several secondary
clinical results of critically ill patients in ICU compared to liberal red-cell
transfusion strategy. Otherwise, restrictive transfusion strategy lowered RBC
transfusion requirements, and was expected to be more cost-effective.
[Acta Inform Med 2025; 33(1.000): 71-78]

anaemia, blood transfusion, critical illness, haemoglobin, intensive care unit