The American College of Physicians (ACP) identified patients who are at risk for cerebral or myocardial ischemic injury if they become volume depleted. These patients may benefit from a more aggressive blood transfusion policy and closer monitoring of blood losses.
Patients at risk for cerebral ischemia:
(1) hemodynamically significant valvular disease
(2) coronary artery disease
(3) congestive heart failure
Patients at risk for myocardial ischemia:
(1) history of transient ischemic attacks (TIA)
(2) history of previous thrombotic stroke
where:
• Other patients with atherosclerotic disease might be at risk for ischemic complications if volume depleted, such as those with renal arterial stenosis or superior mesenteric artery disease.
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