TRAUMA AND TRANSFUSION: Edited by Andrea U. SteinbickerRed cell use in traumaShander, Aryeha,b,c; Zacharowski, Kaid; Spahn, Donat R.e Author Information aDepartment of Anesthesiology and Critical Care Medicine; Englewood Hospital and Medical Center bTeamHealth Research Institute; Englewood cIcahn School Of Medicine at Mount Sinai, New York, NY, USA dDepartment of Anesthesiology, Intensive Care Medicine & Pain Therapy, University Hospital Frankfurt, Goethe University, Frankfurt, Main, Germany eInstitute of Anesthesiology, University and University Hospital Zürich, Zürich, Switzerland Correspondence to Aryeh Shander, MD, Englewood, Hospital and Medical Center, 350 Engle Street, Englewood, NJ 07631, USA. Tel: +1 201 894 3238; fax: +1 201 894 0585; e-mail: [email protected] Current Opinion in Anaesthesiology: April 2020 - Volume 33 - Issue 2 - p 220-226 doi: 10.1097/ACO.0000000000000837 Buy Metrics Abstract Purpose of review Red cell transfusions are commonly used in management of hemorrhage in trauma patients. The appropriate indications and criteria for transfusion are still debated. Here, we summarize the recent findings on the use of red cell transfusion in trauma setting. Recent findings Recent evidence continues to support the long-established link between allogeneic transfusion and worse clinical outcomes, reinstating the importance of more judicious use of allogeneic blood and careful consideration of benefits versus risks when making transfusion decisions. Studies support restrictive transfusion strategies (often based on hemoglobin thresholds of 7–8 g/dl) in most patient populations, although some argue more caution in specific populations (e.g. patients with traumatic brain injury) and more studies are needed to determine if these patients benefit from less restrictive transfusion strategies. It should be remembered that anemia remains an independent risk factor for worse outcomes and red cell transfusion does not constitute a lasting treatment. Anemia should be properly assessed and managed based on the cause and using hematinic medications as indicated. Summary Although the debate on hemoglobin thresholds for transfusion continues, clinicians should not overlook proper management of the underlying issue (anemia). Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.