Real dilemmas regarding blood transfusion.

I n transfusing patients with red blood cells, physicians and surgeons aim to enhance the circulatory oxygen-carrying capacity that has been compromised due to blood loss or a hematological disorder. In general, bleeding and transfusion strongly correlate with adverse outcomes in patients undergoing percutaneous coronary intervention (PCI) (1,2). Understandably, these negative reports have culminated in a higher threshold among physicians to prescribe blood transfusion (3). Nonetheless, there is considerable variation in transfusion practices in U.S. hospitals, and current transfusion guidelines reflect the uncertainty stemming from the available evidence (3,4). The field of interventional cardiology is no exception to this, and the ideal place of blood transfusion around the time of PCI is unclear.