Indications for blood transfusion

Indications for blood transfusion

Blood transfusions should be avoided if possible, and many previous uses of blood and blood products are now no longer considered appropriate. The indications for blood transfusion are as follows: /uni25CF Acute blood loss, to replace circulating volume and main - tain oxygen delivery; /uni25CF Perioperative anaemia, to ensure adequate oxygen delivery during the perioperative phase; /uni25CF Symptomatic chronic anaemia, without haemorrhage or impending surgery . Transfusion trigger Historically , patients were transfused to achieve a haemoglobin >10 /uni00A0 g/dL. This has now been shown not only to be unneces - sary but also to be associated with an increased morbidity and - mortality compared with lower target values. A haemoglobin level of 6 /uni00A0 g/dL is acceptable in patients who are not actively bleeding, those who are not about to undergo major surgery and those who are not symptomatic. There is some controversy as to the optimal haemoglobin level in some patient groups, such as those with cardiovascular disease, sepsis and traumatic brain injury . Although, conceptually , a higher haemoglobin level improves oxygen delivery , there is little clinical evidence at this stage to support higher levels in these groups ( Table 2.6 ). - -

TABLE 2.6 Perioperative red blood cell transfusion criteria. Haemoglobin level (g/dL) Indications <6 Probably will bene /f_i t from transfusion 6–8 Transfusion unlikely to be of bene /f_i t in the absence of bleeding or impending surgery

8 No indication for transfusion in the absence of other risk factors

Indications for blood transfusion

Blood transfusions should be avoided if possible, and many previous uses of blood and blood products are now no longer considered appropriate. The indications for blood transfusion are as follows: /uni25CF Acute blood loss, to replace circulating volume and main - tain oxygen delivery; /uni25CF Perioperative anaemia, to ensure adequate oxygen delivery during the perioperative phase; /uni25CF Symptomatic chronic anaemia, without haemorrhage or impending surgery . Transfusion trigger Historically , patients were transfused to achieve a haemoglobin >10 /uni00A0 g/dL. This has now been shown not only to be unneces - sary but also to be associated with an increased morbidity and - mortality compared with lower target values. A haemoglobin level of 6 /uni00A0 g/dL is acceptable in patients who are not actively bleeding, those who are not about to undergo major surgery and those who are not symptomatic. There is some controversy as to the optimal haemoglobin level in some patient groups, such as those with cardiovascular disease, sepsis and traumatic brain injury . Although, conceptually , a higher haemoglobin level improves oxygen delivery , there is little clinical evidence at this stage to support higher levels in these groups ( Table 2.6 ). - -

TABLE 2.6 Perioperative red blood cell transfusion criteria. Haemoglobin level (g/dL) Indications <6 Probably will bene /f_i t from transfusion 6–8 Transfusion unlikely to be of bene /f_i t in the absence of bleeding or impending surgery

8 No indication for transfusion in the absence of other risk factors

Indications for blood transfusion

Blood transfusions should be avoided if possible, and many previous uses of blood and blood products are now no longer considered appropriate. The indications for blood transfusion are as follows: /uni25CF Acute blood loss, to replace circulating volume and main - tain oxygen delivery; /uni25CF Perioperative anaemia, to ensure adequate oxygen delivery during the perioperative phase; /uni25CF Symptomatic chronic anaemia, without haemorrhage or impending surgery . Transfusion trigger Historically , patients were transfused to achieve a haemoglobin >10 /uni00A0 g/dL. This has now been shown not only to be unneces - sary but also to be associated with an increased morbidity and - mortality compared with lower target values. A haemoglobin level of 6 /uni00A0 g/dL is acceptable in patients who are not actively bleeding, those who are not about to undergo major surgery and those who are not symptomatic. There is some controversy as to the optimal haemoglobin level in some patient groups, such as those with cardiovascular disease, sepsis and traumatic brain injury . Although, conceptually , a higher haemoglobin level improves oxygen delivery , there is little clinical evidence at this stage to support higher levels in these groups ( Table 2.6 ). - -

TABLE 2.6 Perioperative red blood cell transfusion criteria. Haemoglobin level (g/dL) Indications <6 Probably will bene /f_i t from transfusion 6–8 Transfusion unlikely to be of bene /f_i t in the absence of bleeding or impending surgery

8 No indication for transfusion in the absence of other risk factors