Beware Transfusions
Blood transfusion became a mainstay of medicine during the two world wars, where it was used as a last resort to save soldiers who had suffered massive blood loss. But now, far from being restricted to catastrophic bleeding, transfusions are routinely used as an optional treatment, most commonly for patients in intensive care or undergoing major surgery. … The rationale behind such blood transfusions seems incontrovertible. Red cells deliver vital oxygen to tissues, and seriously ill patients who are also anaemic fare less well, so a transfusion should help. Those assumptions went untested for the better part of a century.
Things started to change in 1999 with a randomised controlled trial on 838 critical care patients in Canada that used haemoglobin levels to determine when a blood transfusion was given. Normal levels of haemoglobin … range from 120 to 170 grams per litre. A normal haematocrit – the proportion of red cells in the blood – ranges from 36 to 50 per cent. Doctors decide whether to give a transfusion based on a number of factors, including haemoglobin levels and haematocrit, and the patient’s overall robustness. Many guidelines exist, and practice varies from one hospital or doctor to another, but it is common for patients to receive transfusions when their haemoglobin dips to between 70 and 100 g/l or their haematocrit to 21 to 30 per cent.
But the Canadian study found significantly fewer patients died in hospital, 22 versus 28 per cent, if they received transfusions only when their haemoglobin fell below 70 g/l rather than when it fell below 100 g/l.
A more recent study has found that in heart attack patients with haematocrits of over 25 per cent, a transfusion is associated with more than three times the risk of death or a second heart attack within 30 days compared with not having a transfusion (Journal of the American Medical Association, vol 292, p 1555).
For almost 9000 patients who had heart surgery in the UK between 1996 and 2003, receiving a red cell transfusion was associated with three times the risk of dying in the following year and an almost sixfold risk of dying within 30 days of surgery compared with not receiving one. …
"There is virtually no high-quality study in surgery, or intensive or acute care – outside of when you are bleeding to death – that shows that blood transfusion is beneficial, and many that show it is bad for you," says Gavin Murphy, a cardiac surgeon at the Bristol Heart Institute, who ran the UK study.
Important note from one of the linked studies ("Relationship of Blood Transfusion and Clinical Outcomes in Patients With Acute Coronary Syndromes")
"Finally, because our study was not randomized, it should not be considered as evidence to change practice; rather, it should be considered as evidence that caution is warranted when making transfusion decisions" ...so perhaps "Beware" is a little stronger than those who actually know the limits of their data were willing to go.
I have to disagree with the idea that a special party needs to hear this and that the other special party cannot use it correctly.
#1 our curiosity, impartiality, and morality is being daily lobotomized#2 heuristics such as experts must hear and plebes must fear create #1 which leads to #3#3 a systemic as well as epidemic inability to act even when we are convinced that action must take place
So I would say just QM is reality and CM is a hallucination, the social strata and hierarchy of responsibility is also a hallucination because there has been no upkeep. Curiosity and self examination are increasing discouraged favoring their licentious sisters vanity and relief of boredom.
Let's just say it's amplitude distribution is as wide as a the wavelength of a photon of 1 hertz. It may have been true at one point but since no one bothered to examine and maintain it became spread out.
I would say though that the title of the thread does much more probable harm than the content. We could say the same of the Beware Supplements thread. Both threads have latent and newly emerging biases, which I won't get into.