Clinical practice


Clinical practice

Red cell transfusion

Two questions need to be answered before transfusion of red cells is undertaken:

Some general indications for red cell transfusion are listed in Table 42.1.

Whole blood is now rarely used. Haemorrhage requires transfusion of fluids to maintain blood volume and red cells to raise the haemoglobin level. For correction of anaemia not responsive to other measures red cells stored in ‘optimal additive solution’ are used. There are few indications for red cells stored in plasma.

Practicalities of red cell transfusion

All those involved in the prescription and administration of blood should follow local guidelines with respect to patient identification and the checking of the compatibility and viability of the transfused units. Critical information is contained on the blood bag and the attached compatibility label (Fig 42.1). No discrepancies are permissible. Most serious adverse transfusion reactions are due to transfusion of the wrong blood to the patient (Fig 42.2). Errors can be reduced by newer technologies such as bar coding and radiofrequency chips – these generally rely on machine readable data on patient wristbands.

In shocked patients blood is transfused rapidly, the precise rate dependent on the monitoring of vital signs such as pulse, blood pressure and urine output. Transfusion for correction of anaemia is usually a more elective process. Units of red cells are typically given over 2–4 hours and a rise of around 10 g/L of haemoglobin can be expected from each unit. Red cells are infused via specially designed sterile ‘giving sets’ which contain 170 µm filters. Careful monitoring is particularly important during the first 10 minutes of each unit.

Jun 12, 2016 | Posted by in HEMATOLOGY | Comments Off on Clinical practice

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