Core IM | Internal Medicine Podcast #161 Transfusion Thresholds and the MINT Trial: Beyond Journal Club with NEJM Group
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Oct 2, 2024 The podcast dives into the groundbreaking MINT trial, exploring its potential to reshape anemia treatment in acute myocardial infarction. It contrasts liberal and restrictive transfusion strategies, underscoring how past studies like TRIC have informed current practices. The discussion highlights the risks of increased transfusions and calls for careful anemia management. Insights shed light on personalized approaches to transfusion thresholds, emphasizing the importance of nuanced patient assessments over one-size-fits-all guidelines.
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Transfusion Threshold
- Transfuse patients to a hemoglobin of 7 g/dL.
- This recommendation stems from the TRIC trial and subsequent studies.
Restrictive Transfusion in GI Bleeds
- In the VNU-ABA trial, restrictive transfusion (7 g/dL) in acute GI bleeds reduced mortality by 45%.
- Surprisingly, it also lowered rebleeding rates, contrary to initial assumptions.
Volume Overload Post-Transfusion
- A chronically anemic patient received a transfusion to 6.9 g/dL and IV furosemide before discharge.
- He was readmitted the same evening for volume overload, highlighting transfusion risks.