[Intensive care patients need blood transfusion--with limits. Risks must be weighed against potential benefit]

Anaemia is common in intensive care and its causes multifactorial. Blood transfusion is not without risks and the efficacy of stored blood to increase tissue oxygenation has been questioned. Still, transfusion is common; more than 80% of patients staying more than one week in ICU receive transfusion of more than one unit of red blood cells. Recent data in intensive care patients support that there might be a relation between transfusion and an increased incidence of nosocomial infections as well as increased mortality rate. There is also evidence for a benefit with the use of leucocyte reduced transfusions. With exception for patients with ongoing bleeding, instabile angina, myocardial infarction or COPD during weaning, a restrictive regime with a haemoglobin concentration between 70-90 seems to be without risks.