Indications for Red Cell Transfusion

Abstract

This book describes the many methods and strategies available for decreasing the need for homologous transfusion in cardiac surgery. With respect to red cell transfusion, such techniques as preoperative autologous donation, intraoperative autologous blood donation, intraoperative salvage, and postoperative shed blood infusion clearly help to reduce homologous requirements, and are important components of a comprehensive blood conservation program. There exists, however, another fundamental and yet often overlooked technique that is simple, effective, inexpensive, and complementary to all other blood conservation measures: the technique of minimum safe transfusion.¹ Minimum safe transfusion is the minimization of homologous red cell transfusion through correct application of a clear set of transfusion guidelines based on physiologic principles, experimental data, and clinical experience.² By understanding the physiology of anemia, and then using this knowledge to transfuse the individual patient only when it is necessary to maintain adequate homeostatic function, homologous red cell transfusion can be markedly reduced. Because this reduction is achieved through elimination only of unnecessary transfusions, patient safety is in no way compromised; optimal patient care and minimal homologous blood use are simultaneously achieved.