Haemoglobin triggers and red cell dose in patients with non-acute anaemia

摘要

Women tend to have lower haemoglobin (Hb) levels, and may tolerate anaemia better, than men (Izaks et al., 1999; Karkouti etal, 2008). Women are also usually smaller than men and have estimated blood volumes (EBV) that constitute a lower proportion of body weight than in men. Thus, the volume of dilution for red blood cell (RBC) and other cellular components is generally lower in women and smaller individuals than others (Nadler etal., 1962). Nevertheless, it is uncertain if patient sex and size are considered when determining Hb triggers and targets and RBC doses before transfusion. We performed a prospective audit of consecutive RBC transfusion episodes in non-acutely transfused patients in the day-care unit of a tertiary hospital over 6 months in 2010 to see if there were differences in pre-transfusion Hb triggers and RBC dose depending on patient sex, size or EBV. Patients <=18 years, those with significant acute bleeding, cardiovascular conditions and those requiring transfusions <6 weekly were excluded. Thirteen patients had more than one transfusion episode during this period but only the first was included in the analysis. All patients received standard New Zealand Blood Service leucodepleted RBC units in additive solution with Hct, 0.5-0.7; Hb, >40 g; volume, 220-340 mL (NZBS, 2010).