These results from the CRIT investigators are particularly distressing, since the trial was conducted between August 2000 and April 2001. The findings from the Transfusion Requirements in Critical Care (TRICC) study were published in 1999.13 In that landmark trial, Hebert et al randomized critically ill patients either to a liberal transfusion strategy, with a hemoglobin level goal of 10 g/dL, or to a restrictive protocol, with a hemoglobin level goal of 7 g/dL. The study included > 800 persons, many of whom required MV. At 30 days post-study enrollment, the mortality rate was similar between the two arms of the study, indicating that a restrictive transfusion strategy was at least as safe as a liberal approach.13 More importantly, the results from this project suggested that the greater use of transfusion might actually result in harm to our patients. The hospital mortality rate was higher in those persons randomized to the liberal transfusion strategy arm (28.1% vs 22.2%, respectively; p = 0.05).13 In both younger patients (ie, those < 55 years) and in less severely ill subjects (ie, acute physiology and chronic health evaluation [APACHE] II score, < 20), mortality was significantly lower in the restrictive transfusion cohort.,13Because of continuing controversy regarding the “optimal hemoglobin” level that would facilitate liberation from MV, Hebert and coworkers14 separately analyzed outcomes in subjects requiring MV. Although not designed to expressly explore transfusion and MV, the study by Hebert et al14 reported that the higher hemoglobin goal did not result in shorter durations of MV. In short, nearly a year after the publication of a well-done clinical trial that provided important insight into the management of ICU patients, Levy et al reveal that few intensivists had modified their clinical practice. Failure to alter our treatment algorithms despite clinical studies focused on our patients only underscores the amount of work that remains to be done if critical care is to become an evidence-based specialty.