Faut-‐il accepter un seuil d`hémoglobine plus bas avant de

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Méthodes''
F2-.'%=-&2*6'#2)*9-'%<)*2"##*9-'+%)"#.3=*$('+%63#2)G&('+%E%H%8)3-,'$%,")"&&B&'$:%%
IJ%6'#2)'$%3#2%$-*@*%H00K%,"2*'#2$%.'%,&-$%.'%IL%"#$%".=*$%,3-)%-#'%67*)-)8*'%6").*"9-'%#3#%
-)8'#2':%;'$%,"2*'#2$%(2"*'#2%*#6&-$%,3-)%-#%2"-?%.>7(=38&3<*#'%MN<O%PQ%8R.&%3-%
.>7(="236)*2'%PHJ1%."#$%&'$%$-*2'%.'%&"%67*)-)8*':%;'$%$-S'2$%(2"*'#2%)"#.3=*$($%'#%.'-?%
8)3-,'$%T%&'%,)'=*')%3U%&'$%*#2')@'#"#2$%(2"*'#2%&*<)'$%.'%2)"#$4-$')+%&'%$'63#.%3U%&'%$'-*&%
)'$2)*62*4%.'%N<VJ+/%8R.&%.'@"*2%W2)'%)'$,'62(%"@"#2%23-2'%2)"#$4-$*3#:%;'$%,"2*'#2$%(2"*'#2%'#%
"@'-8&'%,3-)%&"%,)*$'%'#%67")8'%9-*%&'-)%(2"*2%"22)*<-(':%
;'%6)*2B)'%,)*="*)'%(2"*2%-#%6)*2B)'%63=,3$*2'%.'$%*#4'62*3#$%$(@B)'$%'2%.'$%(@(#'='#2$%
*$67(=*9-'$%MXYZ+%*#4")62-$%=($'#2()*9-'%3-%.-%=D36").'+%"22'*#2'%)(#"&'%"*8-[O%."#$%&'$%K%
=3*$%$-*@"#2%&"%)"#.3=*$"2*3#:%;'$%6)*2B)'$%$'63#."*)'$%(2"*'#2%T%&'%#3=<)'%.'%63#6'#2)($%
2)"#$4-$($+%&"%$-)@'#-'%.>-#'%*#4'62*3#%3-%.>-#%(@(#'='#2%*$67(=*9-'%$(,")(='#2+%&"%.-)('%
.'%)("#*="2*3#%3-%.'%$3*#$%*#2'#$*4$+%-#'%63=,&*6"2*3#%,-&=3#"*)'%'2%&"%=3)2"&*2(%23-2'%
6"-$':%;'%.')#*')%,3*#2%.>(@"&-"2*3#%(2"*2%&>(2-.'%.'$%63A2$%'#%&*@)'$%$2')&*#8%'2%'#%.3&&")$:%
Résultats'(
;>(2-.'%"%(2(%='#('%'#2)'%S-*&&'2%H00Q%'2%4(@)*')%H0IK:%K/L/%,"2*'#2$%3#2%.3##(%&'-)%
63#$'#2'='#2%"@"#2%&"%67*)-)8*'+%,")=*%'-?+%H00K%3#2%,-%W2)'%)"#.3=*$($%'2%$-*@*$%MI000%
."#$%&'%<)"$%\%$'-*&%)'$2)*62*4%]%'2%I00K%."#$%&'%<)"$%\%$'-*&%&*<)'%]:%;'$%,"2*'#2$%3#2%<(#(4*6*(%
'#%="S3)*2(%.'%,3#2"8'$%M^0+J1O%3-%-#'%67*)-)8*'%@"&@-&"*)'%MK0+/1O:%H/+J1%.'$%$-S'2$%3#2%
<(#(4*6*(%.>-#'%2)"#$4-$*3#%"@"#2%)"#.3=*$"2*3#:%/K+^1%.'$%,"2*'#2$%.-%8)3-,'%\%)'$2)*62*4%]%
3#2%(2(%2)"#$4-$($%63#2)'%QH+H1%."#$%&'%8)3-,'%\%&*<)'%]%M,P0+00IO%"@'6%)'$,'62*@'='#2%.'$%
=(.*"#'$%E%I%@')$-$%H%6-&32$%)'$,'62*@'='#2:%
F#%2')='$%.>(@B#'='#2$+%*&%#>D%"%,"$%.'%.*44()'#6'$%'#2)'%&'%8)3-,'%\%)'$2)*62*4%]%MK/+I1O%'2%
&'%8)3-,'%\%&*<)'%]%MKK1O%,3-)%&'%6)*2B)'%,)*="*)'%'2%&"%,&-,")2%$3#2%$-)@'#-$%"@"#2%&"%$3)2*'%
.>7G,*2"&:%;"%=3)2"&*2(%'$2%&'%$'-&%6)*2B)'%$'63#."*)'%9-*%$3)2%$*8#*4*6"2*@'='#2+%"@'6%-#'%
"-8='#2"2*3#%.'%&"%=3)2"&*2(%."#$%&'%8)3-,'%\%)'$2)*62*4%]%M,V0+0^/O:%
F#%"#"&D$'%.'%$3-$58)3-,'+%9-"#.%3#%"S3-2'%&'$%"22'*#2'$%)(#"&'$%"*8-[$%"-%6)*2B)'%,)*="*)'+%
&"%.*44()'#6'%.'@*'#2%$*8#*4*6"2*@'%'#%.(4"@'-)%.-%8)3-,'%\%)'$2)*62*4%]%M,V0+0^O:%;"%=W='%
!"#$%"&'()')#"&'*(&Nicolas'BarberAChamoux+&,-(./0-&1-&
2*(1/)3)4/-+&256&23-(%)789:-((*71&;&Guillaume'Baudry+&,-(./0-&1-&
2*(1/)3)4/-+&256&</0=*8&23*$1-&<-(7*(1>& & &&
?-%@(-#&1$&A2:&&& & &&&&&

2'#."#6'%'$2%)'2)3-@('%,3-)%&'%6)*2B)'%,)*="*)'%9-"#.%3#%'?6&-2%&'$%,"2*'#2$%\%2)"#$4-$($%
"@"#2%)"#.3=*$"2*3#%]%.'%&>"#"&D$'%M,V0+0_O:%
F#%2')='%.'%63A2+%&"%=3D'##'%.'$%.(,'#$'$%,3-)%&'$%63#6'#2)($%8&3<-&"*)'$%(2"*2%.'%H_J`%
M^JQaO%."#$%&'%8)3-,'%\%)'$2)*62*4%]%'2%^HJ`%MJIKaO%."#$%&'%8)3-,'%\%&*<)'%]+%="*$%$"#$%
.*44()'#6'%'#2)'%&'$%.'-?%8)3-,'$%,3-)%&'$%63A2%8&3<"-?%T%I0LKL`%MIJJLHaO%'2%I0_I^`%
MI_0/QaO%)'$,'62*@'='#2:%
'
Conclusion'
Z'22'%(2-.'%.>(@"&-"2*3#%.'%&"%2)"#$4-$*3#%."#$%-#'%,3,-&"2*3#%.'%67*)-)8*'%6").*"9-'%#'%
)'2)3-@'%.3#6%,"$%.'%<(#(4*6'%E%-#%$'-*&%)'$2)*62*4%.'%2)"#$4-$*3#%'2%&'$%"#"&D$'$%$'63#."*)'$%
2'#.'#2%=W='%E%=3#2)')%-#%'44'2%.(&(2B)'%"@'6%-#'%"-8='#2"2*3#%.'%&"%=3)2"&*2(:%%%
%
=282,*-)*(*$(A&*-(B#63*/(
A&6*,"'(4,(=*.$,&)$&7*(;,"-.8#.&4-("8$*,(C",/&")(D#,5*,EF(A*./7&B>&?$('=C+&:>!>2>,>+&D*8/-&E/F-+&?>,0>+&
2=(/#&G>&!)4-(#+&E=>H>+&,*(*=&I)(1#J)(8=+&E=>H>+&K3/L*@-8=&G>&,8)F-#+&?>,0>+&A/*77/&H>&G74-3/7/+&
:>!>2>,>+&*71&<*(7*@C&2>&!--.-#+&H>E=/3>&M)(&8=-&NON!-P&O7.-#8/4*8)(#>&N'Engl'J'Med'2015G(KJHTQQJ5
I00_:%!bcT%I0:I0/LRdFef3"I^0KLIH&
722,TRRggg:#6<*:#&=:#*7:83@R,-<='.RH/JL0K/^%