In my series of EBM, I was talking on our grand rounds regarding restrictive vs liberal strategies for blood transfusion! I have already posted the evidence for it. But NEJM published a study in septic shock patient that will really change practice: This is a multi-center, parallel-group trial, they randomly assigned 998 patients in the ICU who had septic shock and they did transfusion when the hemoglobin level was 7 g per deciliter or less (lower threshold) versus when the level was 9 g per deciliter or less (higher threshold) during the ICU stay. The primary outcome measure was death by 90 days after randomization. As other study showed their conclusion is” patients with septic shock who underwent transfusion at a hemoglobin threshold of 7 g per deciliter, as compared with those who underwent transfusion at a hemoglobin threshold of 9 g per deciliter, received fewer transfusions and had similar mortality at 90 days, use of life support, and number of days alive and out of the hospital; the numbers of patients with ischemic events and severe adverse reactions to blood in the ICU were also similar in the two intervention groups.”