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Theodore Iwashyna: Could Hemoglobin Thresholds Lead to Unnecessary Blood Transfusions in ICU Patients?

Theodore Iwashyna/LinkedIn

Oct 29, 2026, 14:36

Theodore Iwashyna: Could Hemoglobin Thresholds Lead to Unnecessary Blood Transfusions in ICU Patients?

Theodore Iwashyna, Bloomberg Distinguished Professor of Social Science and Justice in Medicine at The Johns Hopkins University, shard a post on LinkedIn about a recent article by Nicholas Bosch et al. published in Annals of American Thoracic Society, adding:

“Love this new Nick Bosch, Anica Law, Allan Walkey brief study in Annals of American Thoracic Society of American Thoracic Society

‘In a large US-based, multicenter cohort of ICU patient-days, 60% of hemoglobin concentrations between 6.0 and 6.9 g/dL were followed by spontaneous recovery of hemoglobin to ≥7.0 g/dL in absence of RBC transfusion.

In contrast, subsequent hemoglobin concentrations of <6.0 g/dL in absence of transfusion were rare. In patients who were transfused, models predicted that potentially 90% were more likely than not to have had spontaneous recovery of hemoglobin concentration to ≥ 7.0 g/dL if transfusion had instead been withheld. These results suggest that a large proportion of current hemoglobin threshold-based blood transfusion in the ICU may be unnecessary.’ ”

Title: Spontaneous changes in hemoglobin around common transfusion thresholds during critical illness

Authors: Nicholas Bosch, Anica Law, Allan Walkey

Theodore Iwashyna: Could Hemoglobin Thresholds Lead to Unnecessary Blood Transfusions in ICU Patients?