Anemia and transfusion of red blood cells
- PMID: 24892241
- PMCID: PMC4001991
Anemia and transfusion of red blood cells
Abstract
The red cells transfusion is a mainstay in the treatment of anemic patients. These blood transfusions are not without risks. The risk-benefit profile for red cell transfusions to treat anaemia is uncertain, but they may contribute to adverse patient outcomes in some situations. The ability of a patient to tolerate anaemia depends on their clinical condition and the presence of any significant co-morbidity; maintenance of circulating volume is of paramount importance. There is no universal transfusion trigger. Advances in the development and validation of physiological, accessible, practical and reliable markers to guide therapy are expected. To improve patients' outcomes, further study is required to more fully explore the risk of anemia, optimal hemoglobin level, and the risk and efficacy of RBC transfusion. Future clinical investigations with high priority should determine the efficacy of transfusion in those classified as uncertain scenarios. In the absence of data, it is prudent that transfusion is administered with caution in these clinical scenarios.
La transfusión de glóbulos rojos es uno de los pilares en el tratamiento de pacientes anémicos. Las transfusiones de sangre no están libres de riesgo. Aunque es incierta la relación riesgo-beneficio de las transfusiones para tratar la anemia, estas pueden ocasionar resultados adversos de los pacientes en algunas situaciones. La capacidad de un paciente para tolerar la anemia depende de su estado clínico y la presencia de cualquier co-morbilidad significativa; la preservación del volumen circulante es de suma importancia. No existe un indicador automático universal para la transfusión. Se espera que los avances en el desarrollo y validación de marcadores fisiológicos, accesibles, prácticos y confiables permitan guiar la terapia. Para mejorar los resultados de los pacientes, se requieren más estudios que exploren más a fondo el riesgo de la anemia, el nivel de hemoglobina óptima, y el riesgo y la eficacia de la transfusión de glóbulos rojos. Las investigaciones clínicas futuras con alta prioridad deben determinar la eficacia de la transfusión en los clasificados como escenarios inciertos. Ante la falta de datos, es prudente que la transfusión se administre con precaución en estos escenarios clínicos.
Keywords: anaemia; blood transfusion; transfusion practice.
Conflict of interest statement
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