Does a restrictive transfusion strategy improve outcomes for critically ill patients? The TRICC trial was a landmark randomized controlled trial (RCT) that compared restrictive versus liberal red blood cell transfusion strategies in critically ill patients. The trial enrolled over 800 patients who were admitted to intensive care units with acute illness and randomized them to receive either a restrictive transfusion strategy (transfusions only when hemoglobin levels fell below 7 g/dL) or a liberal strategy (transfusions when hemoglobin levels fell below 10 g/dL). The results of the study demonstrated that the restrictive transfusion strategy was non-inferior to the liberal strategy in terms of 30-day mortality, and was associated with fewer complications and a lower incidence of transfusion-related side effects. This study provided robust evidence that, in critically ill patients, a restrictive approach to red blood cell transfusion—aimed at maintaining hemoglobin levels above 7 g/dL—can safely improve patient outcomes and reduce the risks associated with transfusion. The TRICC trial helped establish restrictive transfusion protocols as the standard of care in critically ill patients, highlighting the importance of avoiding unnecessary transfusions in the ICU.