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We think the evidence supports a restrictive blood transfusion threshold using a haemoglobin concentration (Hb) trigger of 70 g/L in younger, less sick patients in ICUs, especially those without co-existing cardiorespiratory co-morbidity [1, 2]. More liberal transfusion could increase important complications without clinical benefit [3]. In addition, red blood cells are expensive and no trials have demonstrated their cost-effectiveness. Unfortunately, many of our patients are sick, older, and have cardiorespiratory co-morbidity. It is these patients in whom we think individualised transfusion threshold decisions may be needed. Physiological arguments against a blanket restrictive Hb trigger

Should blood transfusion be individualised? We are not sure