Please select the eligibility criteria that correspond to the clinical trial below.
Title: Can a Single-unit Blood Transfusion Protocol in Obstetrics Reduce Total Number of Units Transfused? A Randomized, Controlled Trial
Brief Summary: There is a paucity of data on management of non-acute postpartum anemia. Although blood transfusions were historically initiated with 2 units, the most recent recommendation from the American Association of Blood Banks is to begin with 1 unit. As no randomized controlled trials have been performed in obstetrics, the investigators propose a randomized, controlled trial in non-acute postpartum anemia comparing single- versus multiple-unit transfusion by total numbers of units transfused and maternal morbidity.


Options:
A: Inclusion Criteria:

* Age 18 or older
* Planned cardiac surgery using cardiopulmonary bypass
* Informed consent obtained
* Preoperative European System for Cardiac Operative Risk Evaluation (EuroSCORE I) of 6 or more

Exclusion Criteria:

* Patients who are unable to receive or who refuse blood products
* Patients who are involved in a preoperative autologous pre-donation program
* Patients who are having a heart transplant or having surgery solely for an insertion of a ventricular assist device
* Pregnancy or lactation (a negative pregnancy test must be obtained prior to randomization for women of childbearing potential.)
* Patients who are unable to receive or who refuse blood products
B: Inclusion Criteria:

* Age equal to or greater than 18 years
* Moderate or severe traumatic brain injury, defined as Glasgow coma scale less than or equal to 12 at hospital admission
* Hemoglobin lower than 9.0 g/dL within 7 days from hospital admission

Exclusion Criteria:

* Glasgow coma scale equal to 3 with dilated pupils bilaterally
* Previous neurological sequelae
* Pregnant women
* Jehovah's Witnesses
* Hemorrhagic shock at randomization
* Moribund patients
* Unable to provide consent
C: Inclusion Criteria:

* Women over 18
* Willing and stable to give consent
* \> 6 hours postpartum from any mode of delivery
* Determined by their physician to require blood transfusion either by:

  * Hb \<7g/dL OR
  * \>7g/dL with any sign or symptom of anemia such as fatigue, dizziness, tachycardia, or hypotension
* Agreed to accept blood transfusion
* No contraindications to blood transfusion

Exclusion Criteria:

* hemoglobinopathies
* patients with an ejection fraction \<35%
* Hb \<5 g/dL
* HR \> 130 bpm, BP \< 80/40
D: Inclusion Criteria:

* Has undergone surgical repair for a hip fracture
* Has a postoperative Hgb level below 10 g/dL within three days of surgery
* Diagnosis of cardiovascular disease (e.g., coronary artery disease, congestive heart failure, stroke or transient ischemic attack, or peripheral vascular disease) or cardiovascular risk factors (e.g., diabetes mellitus, hypertension, hypercholesterolemia, tobacco use, or creatinine levels greater than 2.0 mg/dL)

Exclusion Criteria:

* Unable to walk prior to hip fracture
* Declines blood transfusions
* Suffered multiple traumas
* Pathologic fracture of the hip due to malignancy
* Clinically recognized acute myocardial infarction within the 30 days prior to study entry
* Previously participated in the trial and fractured the other hip
* Symptoms associated with anemia (e.g., ischemic chest pain) or actively bleeding at the time of randomization

Answer: C