The following indications for the transfusion of red cells were developed by Bloodworks Northwest medical staff. They are evidence-based to the extent that evidence exists, otherwise they are felt to reflect commonly used good transfusion practice. These indications are intended only as general guidance and may not apply in all clinical situations. The final decision to transfuse or not to transfuse must be made by the patient's physician after consideration of all the clinical circumstances.
Indications for Use of Red Cells:
Red cell transfusion should be given in order to increase oxygen carrying capacity when that capacity is clinically compromised. The Hgb/Hct level alone should not be used to determine the need for transfusion; in addition one must take into consideration the patient's intravascular volume status, evidence of shock, duration and extent of anemia, and cardiopulmonary physiologic parameters.
However, some generalizations are possible.
- Mixed venous O2 sat < 70%
- Respiratory failure, inadequate cardiac output, inadequate oxygenation
- Oncology patients, thrombocytopenia, severe platelet dysfunction
Intra/perioperative or significant bleeding:
Dose: In the absence of acute hemorrhage, transfusion should be given as single units. One unit will usually raise hematocrit by 3-4% in 70kg person.
Monitoring: Hgb/Hct and clinical situation should be evaluated after each unit transfused.
Same as adults
Dose: 10ml/kg should increase hematocrit 6-9%.
Monitoring: Hgb/Hct and clinical situation should be evaluated after each unit transfused