If we have bandwagons, magic bullets, and theoretical constructs, why do we need randomized clinical trials in transfusion medicine and perioperative hemostasis?

摘要

This invited commentary is not so much about science as it is about our lack of knowledge in transfusion medicine and perioperative hemostasis and about how this lack of knowledge affects our practice. As suggested by the title, the intent of this discourse is to be provocative but certainly not contemptuous. Despite widespread collection and administration of red blood cells (81 million units are collected annually worldwide; http://www.who.int/bloodsafety/FactFile2009.pdf), transfusion practice is based on meagre good quality evidence.