The Limits of Acute Anemia
For many years, physicians’ approach to the transfusion of allogeneic red blood cells (RBC) was not individualized. It was accepted that a hemoglobin concentration (Hb) of less than 10 g/dL was a general transfusion threshold and the majority of patients were transfused immediately. In recent years,...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-09-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/18/5279 |
| _version_ | 1797486714602651648 |
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| author | Tina Tomić Mahečić Roxane Brooks Matthias Noitz Ignacio Sarmiento Robert Baronica Jens Meier |
| author_facet | Tina Tomić Mahečić Roxane Brooks Matthias Noitz Ignacio Sarmiento Robert Baronica Jens Meier |
| author_sort | Tina Tomić Mahečić |
| collection | DOAJ |
| description | For many years, physicians’ approach to the transfusion of allogeneic red blood cells (RBC) was not individualized. It was accepted that a hemoglobin concentration (Hb) of less than 10 g/dL was a general transfusion threshold and the majority of patients were transfused immediately. In recent years, there has been increasing evidence that even significantly lower hemoglobin concentrations can be survived in the short term without sequelae. This somehow contradicts the observation that moderate or mild anemia is associated with relevant long-term morbidity and mortality. To resolve this apparent contradiction, it must be recognized that we have to avoid acute anemia or treat it by alternative methods. The aim of this article is to describe the physiological limits of acute anemia, match these considerations with clinical realities, and then present “patient blood management” (PBM) as the therapeutic concept that can prevent both anemia and unnecessary transfusion of RBC concentrates in a clinical context, especially in Intensive Care Units (ICU). This treatment concept may prove to be the key to high-quality patient care in the ICU setting in the future. |
| first_indexed | 2024-03-09T23:37:14Z |
| format | Article |
| id | doaj.art-a4e46bb6ebf346e2ac0b6b7424bebb42 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T23:37:14Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-a4e46bb6ebf346e2ac0b6b7424bebb422023-11-23T16:58:04ZengMDPI AGJournal of Clinical Medicine2077-03832022-09-011118527910.3390/jcm11185279The Limits of Acute AnemiaTina Tomić Mahečić0Roxane Brooks1Matthias Noitz2Ignacio Sarmiento3Robert Baronica4Jens Meier5Department of Anesthesiology and Intensive Care Medicine, University Hospital Center Zagreb—“Rebro”, 10000 Zagreb, CroatiaDepartment of Anesthesiology and Critical Care Medicine, Kepler University Hospital GmbH, Johannes Kepler University, 4040 Linz, AustriaDepartment of Anesthesiology and Critical Care Medicine, Kepler University Hospital GmbH, Johannes Kepler University, 4040 Linz, AustriaDepartment of Anesthesiology, Clinica Santa Maria, Santiago 7520378, ChileDepartment of Anesthesiology and Intensive Care Medicine, University Hospital Center Zagreb—“Rebro”, 10000 Zagreb, CroatiaDepartment of Anesthesiology and Critical Care Medicine, Kepler University Hospital GmbH, Johannes Kepler University, 4040 Linz, AustriaFor many years, physicians’ approach to the transfusion of allogeneic red blood cells (RBC) was not individualized. It was accepted that a hemoglobin concentration (Hb) of less than 10 g/dL was a general transfusion threshold and the majority of patients were transfused immediately. In recent years, there has been increasing evidence that even significantly lower hemoglobin concentrations can be survived in the short term without sequelae. This somehow contradicts the observation that moderate or mild anemia is associated with relevant long-term morbidity and mortality. To resolve this apparent contradiction, it must be recognized that we have to avoid acute anemia or treat it by alternative methods. The aim of this article is to describe the physiological limits of acute anemia, match these considerations with clinical realities, and then present “patient blood management” (PBM) as the therapeutic concept that can prevent both anemia and unnecessary transfusion of RBC concentrates in a clinical context, especially in Intensive Care Units (ICU). This treatment concept may prove to be the key to high-quality patient care in the ICU setting in the future.https://www.mdpi.com/2077-0383/11/18/5279anemiatransfusion thresholdpatient blood management |
| spellingShingle | Tina Tomić Mahečić Roxane Brooks Matthias Noitz Ignacio Sarmiento Robert Baronica Jens Meier The Limits of Acute Anemia Journal of Clinical Medicine anemia transfusion threshold patient blood management |
| title | The Limits of Acute Anemia |
| title_full | The Limits of Acute Anemia |
| title_fullStr | The Limits of Acute Anemia |
| title_full_unstemmed | The Limits of Acute Anemia |
| title_short | The Limits of Acute Anemia |
| title_sort | limits of acute anemia |
| topic | anemia transfusion threshold patient blood management |
| url | https://www.mdpi.com/2077-0383/11/18/5279 |
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