Critical care: restrictive transfusion threshold: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Critical care: restrictive transfusion threshold

Sample item

What haemoglobin threshold is generally used for red cell transfusion in a stable critically ill adult without active bleeding or myocardial ischaemia?

A12 g/dLB10 g/dLC5 g/dLD7 g/dL

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. 7 g/dL

The TRICC and later trials showed that a restrictive strategy with a threshold of 7 g/dL is as safe as a liberal one in most critically ill patients. Higher thresholds of 8 g/dL or more are used in cardiovascular disease and acute coronary syndrome. Active bleeding is treated by clinical judgement.

Option by option

A. 12 g/dL
12 g/dL exposes patients to unnecessary transfusion.
B. 10 g/dL
10 g/dL is an outdated liberal threshold.
C. 5 g/dL
5 g/dL is below accepted thresholds.
D. 7 g/dL (correct)
Correct. 7 g/dL is the restrictive threshold.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is D, 7 g/dL. The TRICC and later trials showed that a restrictive strategy with a threshold of 7 g/dL is as safe as a liberal one in most critically ill patients.

Why is "12 g/dL" not the answer?

12 g/dL exposes patients to unnecessary transfusion.

Why is "10 g/dL" not the answer?

10 g/dL is an outdated liberal threshold.

Why is "5 g/dL" not the answer?

5 g/dL is below accepted thresholds.

What concept does this question test?

It tests Critical care: restrictive transfusion threshold in Anaesthesia. Higher thresholds of 8 g/dL or more are used in cardiovascular disease and acute coronary syndrome. Active bleeding is treated by clinical judgement.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Critical care: restrictive transfusion threshold?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.