II. When should we transfuse critically ill and perioperative patients with known coronary artery disease? †

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Abstract
Red blood cell (RBC) transfusion is a life‐saving therapy for major haemorrhage. However, many RBC transfusions prescribed for surgical patients or critically ill patients in the intensive care unit (ICU) are to increase haemoglobin concentration when clinically significant bleeding is not present or has stopped.1–3 In these situations the potential benefits of RBC transfusion need to be balanced against the risks associated with it. Transmission of known viral infections by RBC transfusion is extremely rare and the much‐debated importance of donor leucocytes is no longer relevant in the UK (and in an increasing number of other countries) because all blood components are leucodepleted before storage. However, other serious complications such as incompatible transfusion resulting from administration errors, and cases of transfusion‐associated lung injury (TRALI) continue to occur and to cause significant morbidity and mortality.4