**3.1 Individualize transfusion threshold**

A restrictive transfusion strategy (transfusion threshold at hemoglobin 7 g/dl) must be used, taking into consideration anemia risks and the benefits from a transfusion in an individualized way for every patient. Nowadays, rarely does hemoglobin over 10 g/dl get considered for transfusion, whereas it is believed to be strictly necessary when hemoglobin is less than 6 g/dl. In either case, the transfusion threshold must be lowered to try and delay the start of blood transfusion until the surgery ends, making a new assessment after each transfused packed red blood cells. Moreover, the usual practice of transfusing always two units of packed red blood cells (PRBC) is considered incorrect; as to raise the hemoglobin concentration 1 g/dl it takes about 4 ml/kg PRBC, being enough one PRBC.
