This study shows a group of MICU physicians altered transfusion practice after the publication of the TRICC trial results and that, in the years following, transfusion practice has remained closer to the restrictive transfusion strategy proposed by the TRICC investigators than to older conventions.

The rate of change varied over time interval and according to patient MICU admission Hgb level.

The rate of change in transfusion practice decreased over time, but implementation of more restrictive transfusion strategies continued years after the initial large shifts in practice.

These changes occurred without an internal dictum. Though important change occurred in our MICU, the potential may exist for further application of evidence-based guidelines to our transfusion practices.

Institutions should review their ICU blood transfusion practices and consider interventions that may be effective in reducing inappropriate pRBC use.

These practices should be assessed over a period of time sufficient for their evaluation—perhaps on the order of a decade.

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