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In this review, we aim to discuss the interplay between benefits and potential adverse effects of transfusion in critically ill children by including 65 papers, which were evaluated based on previously agreed selection criteria. Current practice on transfusing critically ill children is mainly founded on the basis of adult studies, common practices with cut\u2010off values, and expert opinions, rather than evidence\u2010based medicine. Paediatric patients have explicit physiological challenges and requirements to be addressed. Critically ill children often suffer from anaemia, have substantial iatrogenic blood loss with subsequent transfusions, and are at a higher risk of complications, often due to human errors. Transfusion in children is associated with increased morbidity. A restrictive transfusion strategy is not associated with increased morbidity. Thus, transfusion in paediatrics should be considered a high\u2010risk treatment and requires individual clinical assessment. Current level of evidence support the notion that in most stable cases, despite high severity of illness (cyanotic children and neonates excluded), a restrictive haemoglobin threshold of 70\u2009g\/l (4.3\u2009mmol\/l) is no more harmful than to transfuse at a liberal trigger, e.g. haemoglobin 95\u2009g\/l (5.9\u2009mmol\/l). Thus, balanced against potential benefits and often its necessity, a restrictive approach may be appropriate due to the associated risks of transfusion.<\/jats:p>","DOI":"10.1111\/aas.12131","type":"journal-article","created":{"date-parts":[[2013,5,22]],"date-time":"2013-05-22T02:06:41Z","timestamp":1369188401000},"page":"684-691","source":"Crossref","is-referenced-by-count":30,"title":["Transfusion in critically ill children: an ongoing dilemma"],"prefix":"10.1111","volume":"57","author":[{"given":"E. 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