Inhaled glucocorticoids and COPD exacerbations.

n engl j med 372;1 nejm.org january 1, 2015 92 for transfusion in our clinical setting.3 The benefit of using the lactate level and Scvo2 to initiate and guide early resuscitation, including transfusion, in patients with septic shock may be questioned after the results of recent randomized trials.4,5 As compared with the high-quality data from these trials, the results of any post hoc subgroup analyses that we may do are less valid. Gordillo-Escobar et al. speculate that the age of blood and storage lesion could bias the results of our trial. Transfusion practice in patients with septic shock was not based on the age of blood at the TRISS trial sites. These factors may be important, and data from ongoing randomized trials will help us to understand whether the age of blood affects the outcome of critically ill patients (Standard Issue Transfusion versus Fresher Red Blood Cell Use in Intensive Care [TRANSFUSE] trial [ClinicalTrials.gov number, NCT01638416] and the Age of Blood Evaluation [ABLE] trial [Current Controlled Trials number, ISRCTN44878718]). Lars B. Holst, M.D. Jørn Wetterslev, M.D., Ph.D. Anders Perner, M.D., Ph.D.